Individual provider Active NPI

Jordan Clyde Claborn, PHARMD

  • Pharmacist
  • Lawrenceburg, KY
National Provider Identifier
1770184848
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
019209 Issued in KY
Practice address
1000 Bypass S
Lawrenceburg, KY 40342-8033
Phone
(502) 839-3403
NPI assigned
Nov 5, 2020
Last updated
Nov 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 019209 KY Primary

Addresses

Primary practice location

1000 Bypass S
Lawrenceburg, KY 40342-8033

Mailing address

1212 Autumn Ridge Dr
Lexington, KY 40509-2542
Phone (859) 300-1693

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
019209KYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1770184848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 AUTUMN RIDGE DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092542",
            "telephone_number": "859-300-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BYPASS S",
            "city": "LAWRENCEBURG",
            "state": "KY",
            "postal_code": "403428033",
            "telephone_number": "502-839-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLABORN",
        "first_name": "JORDAN",
        "middle_name": "CLYDE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "019209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceburg, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.