Active NPI
Everett-Jackson Thorne Young, PHARM.D.
- Pharmacist
- Walterboro, SC
National Provider Identifier
1811151129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11543
- Practice address
- 1326 N Jefferies Blvd
Walterboro, SC 29488-2733 - Phone
- (843) 549-6781
- Fax
- (843) 549-9642
- NPI assigned
- Jul 16, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | 11543 | SC | Primary |
Addresses
Primary practice location
1326 N Jefferies Blvd
Walterboro, SC 29488-2733
Mailing address
PO Box 766
Folly Beach, SC 29439-0766
Phone (843) 549-6781
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11543 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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": "1216166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216166400000",
"number": "1811151129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 766",
"city": "FOLLY BEACH",
"state": "SC",
"postal_code": "294390766",
"telephone_number": "843-549-6781",
"fax_number": "843-549-9642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1326 N JEFFERIES BLVD",
"city": "WALTERBORO",
"state": "SC",
"postal_code": "294882733",
"telephone_number": "843-549-6781",
"fax_number": "843-549-9642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "EVERETT-JACKSON",
"middle_name": "THORNE",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-16",
"last_updated": "2008-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "11543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walterboro, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.