Individual provider Active NPI

John Jason McDaniel, PHARMD

  • Pharmacist
  • Wilmore, KY
National Provider Identifier
1821693151
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
012705 Issued in KY
Practice address
201 E Main St
Wilmore, KY 40390-1321
Phone
(859) 858-2453
Fax
(859) 858-2436
NPI assigned
Dec 3, 2020
Last updated
Dec 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 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 012705 KY Primary

Addresses

Primary practice location

201 E Main St
Wilmore, KY 40390-1321

Mailing address

201 E Main St
Wilmore, KY 40390-1321
Phone (859) 858-2453

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
012705KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmore Pharmacist Group, LLC CurrentSince Dec 29, 2024 Accepting new patients
Wilmore Pharmacist Group, LLC CurrentSince Dec 6, 2020 Accepting new patients

Locations

201 E Main St
Wilmore, KY 40390
Phone (859) 858-2453

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1821693151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MAIN ST",
            "city": "WILMORE",
            "state": "KY",
            "postal_code": "403901321",
            "telephone_number": "859-858-2453",
            "fax_number": "859-858-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E MAIN ST",
            "city": "WILMORE",
            "state": "KY",
            "postal_code": "403901321",
            "telephone_number": "859-858-2453",
            "fax_number": "859-858-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "JOHN",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "012705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmore, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.