Jordan Timothy Beatty

Primary specialty

PharmacistTaxonomy code 183500000X

License

19542 Issued in AL

Practice address

9917A Spanish Fort Blvd
Spanish Fort, AL 36527-5603

Phone

(251) 626-3113

NPI assigned

May 7, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Alabama CVS Pharmacy LLC

  • Pharmacy
  • Auburn, AL
  • NPI 1619668076
  NPD (past)

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1831534635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9917A SPANISH FORT BLVD",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "365275603",
            "telephone_number": "251-626-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9917A SPANISH FORT BLVD",
            "city": "SPANISH FORT",
            "state": "AL",
            "postal_code": "365275603",
            "telephone_number": "251-626-3113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1609 Wildwood Crossings",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352116410",
            "country_code": "US",
            "telephone_number": "478-361-3148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEATTY",
        "first_name": "JORDAN",
        "middle_name": "TIMOTHY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-07",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AL",
            "license": "S10665",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "19542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry Lee Booth, D.M.D., P.C.
• Amy Bauer
• Bay Podiatry, L.L.C.
• Deana Beard, APRN
• Lily Beasley, MS, RDN
• Benchmark Physical Therapy of Alabama, LLC
• Madeline Bent
• Birmingham Recovery Center Inc.
• Bloom and Grow Counseling and Wellness LLC
• Maria Boccardo

• All providers in Spanish Fort, AL
• Pharmacist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.