Jon Eric Jordan

Primary specialty

PharmacistTaxonomy code 183500000X

License

14229 Issued in MD

Practice address

610 9TH Ave
Brunswick, MD 21716-1828

Phone

(301) 834-9715

Fax

(301) 834-4414

NPI assigned

Jan 6, 2021

Last updated

Jan 6, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Medicine Plus Brunswick

  • Community/Retail Pharmacy
  • Brunswick, MD
  • NPI 1568524171
  Authorized official Same address or phone

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1922696707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 9TH AVE",
            "city": "BRUNSWICK",
            "state": "MD",
            "postal_code": "217161828",
            "telephone_number": "301-834-9715",
            "fax_number": "301-834-4414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 9TH AVE",
            "city": "BRUNSWICK",
            "state": "MD",
            "postal_code": "217161828",
            "telephone_number": "301-834-9715",
            "fax_number": "301-834-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JON",
        "middle_name": "ERIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "14229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "922221",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "2119053",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Leigh Heister, RN, IBCLC
• Chan-Hing Ho, M.D.
• Zachary Howard, MS, LAT, ATC
• Ashley Ippolito
• Heather Dawn Jones, FNP-C
• Diana Grace Kassman, LCPC
• Timothy Keith, PHARMD
• Annette Kerr, LCSW-C
• Atta Panyin Kesse, PHARM.D,MBA
• Amudalat King

• Pharmacist in Brunswick, MD
• Providers in Brunswick, MD by specialty
• Pharmacist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.