Individual provider Active NPI

Mandy Shealey Poston, PHARMD.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Fort Jackson, SC
National Provider Identifier
1558469692
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
10620 Issued in SC
Practice address
4500 Stuart Street
Moncrief Army Community Hospital/Credentials
Fort Jackson, SC 29207-5720
Phone
(803) 751-2024
Fax
(803) 751-2689
NPI assigned
Sep 20, 2006
Last updated
Jun 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 010620 SC
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 10620 SC Primary

Addresses

Primary practice location

4500 Stuart Street
Moncrief Army Community Hospital/Credentials
Fort Jackson, SC 29207-5720

Mailing address

4500 Stuart Street
Moncrief Army Community Hospital Attn: MCXL-PQ
Fort Jackson, SC 29207-5720
Phone (803) 751-2024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
10620SCMDProfessional Counselor
010620SCMDPharmacotherapy Pharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1558469692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 STUART STREET",
            "address_2": "MONCRIEF ARMY COMMUNITY HOSPITAL ATTN: MCXL-PQ",
            "city": "FORT JACKSON",
            "state": "SC",
            "postal_code": "292075720",
            "telephone_number": "803-751-2024",
            "fax_number": "803-751-2689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 STUART STREET",
            "address_2": "MONCRIEF ARMY COMMUNITY HOSPITAL/CREDENTIALS",
            "city": "FORT JACKSON",
            "state": "SC",
            "postal_code": "292075720",
            "telephone_number": "803-751-2024",
            "fax_number": "803-751-2689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POSTON",
        "first_name": "MANDY",
        "middle_name": "SHEALEY",
        "name_prefix": "Dr.",
        "credential": "PHARMD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "SC",
            "license": "010620",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "SC",
            "license": "10620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Jackson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.