Active NPI
Jacelyn L Kershaw
- Pharmacist
- Ocean Isle Beach, NC
National Provider Identifier
1730956822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17057
- Practice address
- 7295 Beach Dr SW
Ocean Isle Beach, NC 28469-5515 - Phone
- (910) 579-0970
- NPI assigned
- Dec 7, 2023
- Sex
- Female
- 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 | 17057 | NC | Primary |
Addresses
Primary practice location
7295 Beach Dr SW
Ocean Isle Beach, NC 28469-5515
Mailing address
920 Laurens Mill Dr
Myrtle Beach, SC 29579-3555
Phone (336) 848-1208
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17057 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701907200000",
"number": "1730956822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 LAURENS MILL DR",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295793555",
"telephone_number": "336-848-1208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7295 BEACH DR SW",
"city": "OCEAN ISLE BEACH",
"state": "NC",
"postal_code": "284695515",
"telephone_number": "910-579-0970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERSHAW",
"first_name": "JACELYN",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-07",
"last_updated": "2023-12-07",
"certification_date": "2023-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "17057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ocean Isle Beach, NC
- Lisa Christine Hill, CCC-SLP, BCS-CL
- Linda Eileen Janowski, RPH
- Deanna Marie Jones, ATC
- Rebecca Justice, RPH
- K. Jasinski, D.M.D., P.C. (Dental Care on Causeway)
- Mikayla Brianne Kinsey, PT, DPT
- Bruce Le
- Loris Community Hospital District (Sunset Beach Internal Medicine)
- McLeod Physician Associates II (McLeod Seacoast Endocrinology Associates)
- James Edward McNeil, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.