Jordan Mackenzie Young, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PD13260 Issued in AR

Practice address

105 Highway 165 S
Portland, AR 71663-9251

Phone

(870) 737-2813

Fax

(870) 737-2781

NPI assigned

Oct 18, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Portland Drug LLC

  • Community/Retail Pharmacy
  • Portland, AR
  • NPI 1942611504
  NPD
• Portland Drug Inc.

  • Community/Retail Pharmacy
  • Portland, AR
  • NPI 1578770582
  NPD (past)

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1659034643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73",
            "city": "PORTLAND",
            "state": "AR",
            "postal_code": "716630073",
            "telephone_number": "870-737-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HIGHWAY 165 S",
            "city": "PORTLAND",
            "state": "AR",
            "postal_code": "716639251",
            "telephone_number": "870-737-2813",
            "fax_number": "870-737-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JORDAN",
        "middle_name": "MACKENZIE",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD13260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mainline Health Systems, Inc
• Mainline Health Systems, Inc
• Byron K Montgomery, ANP
• Portland Drug Inc.
• Portland Drug LLC

• Pharmacist in Portland, AR
• Providers in Portland, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.