Jordan Blackstone, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

60276 Issued in SC

Practice address

2830 Highway 52
Moncks Corner, SC 29461-5075

Phone

(843) 809-6083

NPI assigned

Aug 2, 2024

Sex

Female

Sole proprietor

No

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.

• Publix Super Markets, Inc.

  • Community/Retail Pharmacy
  • Moncks Corner, SC
  • NPI 1629711809
  NPD
• Publix Super Markets Inc

  • Community/Retail Pharmacy
  • Winter Haven, FL
  • NPI 1760356380
  NPD (past)

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

{
    "created_epoch": "1722556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1689404089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 LAKELYN RD",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294618373",
            "telephone_number": "843-329-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 HIGHWAY 52",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294615075",
            "telephone_number": "843-809-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSTONE",
        "first_name": "JORDAN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-08-02",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "SC",
            "license": "60276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Glass Berry, N.M.T.
• Katie Bert, DPT
• Faith Bevins, PTA
• Bi-Lo Pharmacy
• Julie Black
• Suzanne Morris Blakeley, FNP
• Sophia Bay Blumberg, BS
• Laronda Boddie
• Ruston George Boland, R.PH.
• Lindsay K Bolster, LPC

• All providers in Moncks Corner, SC
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.