Active NPI
Robert Andrew Jordan, RPH
- Pharmacist
- Hamburg, NY
National Provider Identifier
1710050265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 029216
- Practice address
- 140 Pine St
Hamburg, NY 14075 - Phone
- (716) 649-9505
- Fax
- (716) 649-9260
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 029216 | NY | Primary |
Addresses
Primary practice location
140 Pine St
Hamburg, NY 14075
Mailing address
678 Kaymar Dr
Buffalo, NY 14228-3461
Phone (716) 691-5677
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 029216 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710050265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "678 KAYMAR DR",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142283461",
"telephone_number": "716-691-5677",
"fax_number": "716-649-9260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 PINE ST",
"city": "HAMBURG",
"state": "NY",
"postal_code": "14075",
"telephone_number": "716-649-9505",
"fax_number": "716-649-9260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "ROBERT",
"middle_name": "ANDREW",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "029216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.