Active NPI
Jessica Miles Black
- Pharmacist
- Anderson, SC
National Provider Identifier
1871227355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 43510
- Practice address
- 922 Highway 28 Byp
Anderson, SC 29624-1114 - Phone
- (864) 224-7469
- NPI assigned
- Jul 12, 2022
- Last updated
- Jul 12, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 43510 | SC | Primary |
Addresses
Primary practice location
922 Highway 28 Byp
Anderson, SC 29624-1114
Mailing address
142 Pine Lake RNCH
Belton, SC 29627-8865
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43510 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657584000000",
"number": "1871227355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "142 PINE LAKE RNCH",
"city": "BELTON",
"state": "SC",
"postal_code": "296278865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "922 HIGHWAY 28 BYP",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296241114",
"telephone_number": "864-224-7469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "JESSICA",
"middle_name": "MILES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-12",
"last_updated": "2022-07-12",
"certification_date": "2022-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "43510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anderson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.