Individual provider Active NPI

Lucas Max Brown, PHARM. D.

  • Pharmacist
  • Gilbert, AZ
National Provider Identifier
1043569601
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S025727 Issued in AZ
Practice address
714 S Val Vista Dr
Gilbert, AZ 85296-3140
Phone
(480) 654-9337
NPI assigned
Aug 29, 2012
Last updated
Jul 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.295779 IL
Pharmacist 183500000X S025727 AZ Primary

Addresses

Primary practice location

714 S Val Vista Dr
Gilbert, AZ 85296-3140

Mailing address

1233 S Gilbert Rd Apt 5306
Gilbert, AZ 85296-4602
Phone (217) 273-7588

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

LicenseStateTypeSpecialty
S025727AZMDPharmacist
051.295779ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Smiths Food & Drug Centers Inc PastSince Jul 10, 2022 Accepting new patients
Smith's Food & Drug Centers Inc PastSince Jul 10, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1043569601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 S GILBERT RD APT 5306",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964602",
            "telephone_number": "217-273-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 S VAL VISTA DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963140",
            "telephone_number": "480-654-9337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "LUCAS",
        "middle_name": "MAX",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-29",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.295779",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S025727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

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

Verify at the official NPI Registry.