Individual provider Active NPI

Brandon Mitchell Van Zile, PHARMD

  • Pharmacist
  • Louisville, KY
National Provider Identifier
1053083261
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
023112 Issued in KY
Practice address
2225 W Broadway
Louisville, KY 40211-1003
Phone
(502) 774-8296
NPI assigned
Oct 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pharmacist 183500000X 023112 KY Primary

Addresses

Primary practice location

2225 W Broadway
Louisville, KY 40211-1003

Mailing address

946 Goss Ave Apt 7110
Louisville, KY 40217-2285
Phone (502) 655-0509

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
023112KYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1053083261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "946 GOSS AVE APT 7110",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402172285",
            "telephone_number": "502-655-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111003",
            "telephone_number": "502-774-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN ZILE",
        "first_name": "BRANDON",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-05",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "023112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

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

Verify at the official NPI Registry.