Active NPI
Jon Gary Comden II, RPH
- Pharmacist
- Holly Springs, NC
National Provider Identifier
1871629337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19274
- Practice address
- 5277 Sunset Lake Rd
Holly Springs, NC 27540-3768 - Phone
- (919) 363-4729
- Fax
- (919) 363-9849
- NPI assigned
- Feb 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302023100 | MI | |
| Pharmacist | 183500000X | 19274 | NC | Primary |
Addresses
Primary practice location
5277 Sunset Lake Rd
Holly Springs, NC 27540-3768
Mailing address
225 Braxcarr St
Holly Springs, NC 27540-7645
Phone (919) 552-7971
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5302023100 | Other | MI | PHARMACIST LICENSE NUMBER |
| 19274 | Other | NC | NORTH CAROLINA PHARMACY LICENSE |
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302023100 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harris Teeter, LLC | Past | Accepting new patients | |
| Harris Teeter LLC | 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.
-
- Community/Retail Pharmacy
- Apex, NC
- NPI 1225856859
-
- Community/Retail Pharmacy
- Holly Springs, NC
- NPI 1770685158
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214265600000",
"number": "1871629337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 BRAXCARR ST",
"city": "HOLLY SPRINGS",
"state": "NC",
"postal_code": "275407645",
"telephone_number": "919-552-7971",
"fax_number": "919-363-9849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5277 SUNSET LAKE RD",
"city": "HOLLY SPRINGS",
"state": "NC",
"postal_code": "275403768",
"telephone_number": "919-363-4729",
"fax_number": "919-363-9849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COMDEN",
"first_name": "JON",
"middle_name": "GARY",
"name_prefix": "Mr.",
"name_suffix": "II",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-26",
"last_updated": "2008-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302023100",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "19274",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE NUMBER",
"identifier": "5302023100",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH CAROLINA PHARMACY LICENSE",
"identifier": "19274",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Holly Springs, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.