Active NPI
Jonathan Glen Hubanks, PHARMD
- Pharmacist
- Clinton, MS
National Provider Identifier
1962929331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E-09835
- Practice address
- 202 Clinton Blvd
Clinton, MS 39056-5126 - Phone
- (601) 924-3232
- Fax
- (601) 924-2417
- NPI assigned
- Aug 27, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-09835 | MS | Primary |
Addresses
Primary practice location
202 Clinton Blvd
Clinton, MS 39056-5126
Mailing address
202 Clinton Blvd
Clinton, MS 39056-5126
Phone (601) 924-3232
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-09835 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freds Stores of Tennessee Inc | Past | Accepting new patients |
Organizations & group practices 1
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
- Greenville, MS
- NPI 1093969016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1962929331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 CLINTON BLVD",
"city": "CLINTON",
"state": "MS",
"postal_code": "390565126",
"telephone_number": "601-924-3232",
"fax_number": "601-924-2417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 CLINTON BLVD",
"city": "CLINTON",
"state": "MS",
"postal_code": "390565126",
"telephone_number": "601-924-3232",
"fax_number": "601-924-2417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBANKS",
"first_name": "JONATHAN",
"middle_name": "GLEN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-27",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-09835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.