Jonathan Michael Beam, PHARMD
Individual provider Active NPI Pharmacist · Wake Forest, NC
NPI 1831538792 · NPPES record last updated Jan 9, 2014
Key facts
- NPI
- 1831538792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 23291 (NC)
- Practice address
- 12000 Retail Dr
Wake Forest, NC 27587-7353 - Phone
- (919) 761-1002
- NPI assigned
- Jun 24, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23291 | NC | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 23291 | NC | Yes |
Addresses
Primary practice location
12000 Retail Dr
Wake Forest, NC 27587-7353
Mailing address
12000 Retail Dr
Wake Forest, NC 27587-7353
Phone (919) 761-1002
NPI Registry JSON
{
"created_epoch": "1372032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389225600000",
"number": "1831538792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12000 RETAIL DR",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275877353",
"telephone_number": "919-761-1002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12000 RETAIL DR",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275877353",
"telephone_number": "919-761-1002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAM",
"first_name": "JONATHAN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-24",
"last_updated": "2014-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "23291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wake Forest, NC
- Michelle Kathlyn Bates
- Angel Krystal Battle
- Sarah Baxt
- Yevgeniya Bayda
- Beacon Behavioral Health, PLLC
- Robert Lee Beamon Jr.
- Jalecia Alexandria Beatty
- Brandon Beaver
- Angela Beebe
- Belgat and Associates PLLC
All providers in Wake Forest, NC · Pharmacist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.