Active NPI
Brandon Utter, PHARM.D.
- Psychiatric Pharmacist
- Leavenworth, KS
National Provider Identifier
1023385226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- 03440500
- Practice address
- 4101 S 4TH St
Leavenworth, KS 66048-5014 - Phone
- (785) 218-1415
- NPI assigned
- Nov 17, 2011
- 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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 1-15451 | KS | |
| Psychiatric Pharmacist | 1835P1300X | 03440500 | OH | Primary |
Addresses
Primary practice location
4101 S 4TH St
Leavenworth, KS 66048-5014
Mailing address
9139 Dr Korczak Ter
Skokie, IL 60076-1746
Phone (785) 218-1415
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 |
|---|---|---|---|
| 1-15451 | KS | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 03440500 | OH | MD | Psychiatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668556800000",
"number": "1023385226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9139 DR KORCZAK TER",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600761746",
"telephone_number": "785-218-1415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 S 4TH ST",
"city": "LEAVENWORTH",
"state": "KS",
"postal_code": "660485014",
"telephone_number": "785-218-1415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UTTER",
"first_name": "BRANDON",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-17",
"last_updated": "2022-11-16",
"certification_date": "2022-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "KS",
"license": "1-15451",
"primary": false
},
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "OH",
"license": "03440500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leavenworth, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.