Brian Alan Casebolt

Primary specialty

PharmacistTaxonomy code 183500000X

License

043946 Issued in MO

Practice address

937 Park Circle Dr
Brookfield, MO 64628-7920

Phone

(660) 258-7404

NPI assigned

Nov 10, 2020

Last updated

Nov 10, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wal-Mart Stores East LP

  dba Walmart Pharmacy 10-0203

  • Community/Retail Pharmacy
  • Brookfield, MO
  • NPI 1609893924
  NPD (past)
• Wal-Mart Stores East, LP

  dba Walmart Pharmacy 10-2229

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1023610433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26713 IRA DR",
            "city": "BROOKFIELD",
            "state": "MO",
            "postal_code": "646288391",
            "telephone_number": "660-734-0989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 PARK CIRCLE DR",
            "city": "BROOKFIELD",
            "state": "MO",
            "postal_code": "646287920",
            "telephone_number": "660-258-7404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEBOLT",
        "first_name": "BRIAN",
        "middle_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "043946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brookfield SNF Opco LLC (Brookfield Health Care Center)
• Pamela Brown, RD/LD
• Kristen Marie Butterfield, RPT
• Gail Calvert, FNP-BC
• Audra Carriker, PHARM D
• Karla Denise Clubine, FNP/PNP
• Minerva C Concepcion-Rivera, MD
• Alexander Cosby, PHARMD
• Amy Creason, FNP
• Creative Pathways Residential Supports

• Pharmacist in Brookfield, MO
• Providers in Brookfield, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.