NPIMap

Individual provider Active NPI

Jeremy Kevin Mullinnix, PHARMD

  • Pharmacist
  • Lyman, SC
National Provider Identifier
1801280599
Registry record updated Mar 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
35962 Issued in SC
Practice address
200 Spartanburg Hwy
Lyman, SC 29365-1808
Phone
(864) 949-0800
Fax
(864) 949-0803
NPI assigned
Mar 20, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 35962 SC Primary

Addresses

Primary practice location

200 Spartanburg Hwy
Lyman, SC 29365-1808

Mailing address

200 Spartanburg Hwy
Lyman, SC 29365-1808
Phone (864) 949-0800

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

Practice roles

OrganizationSpecialtyStatusNew patients
Freds Stores of Tennessee Inc Past Accepting new patients
Freds Stores of Tennessee Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1426809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1801280599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SPARTANBURG HWY",
            "city": "LYMAN",
            "state": "SC",
            "postal_code": "293651808",
            "telephone_number": "864-949-0800",
            "fax_number": "864-949-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SPARTANBURG HWY",
            "city": "LYMAN",
            "state": "SC",
            "postal_code": "293651808",
            "telephone_number": "864-949-0800",
            "fax_number": "864-949-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINNIX",
        "first_name": "JEREMY",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-20",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "35962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyman, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.