Caleb David Braasch

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

051303293 Issued in IL

Practice address

1818 South Airport Rd
Decatur, IL 62521

Phone

(217) 864-5912

NPI assigned

Sep 16, 2020

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

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1053927988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 SOUTH AIRPORT ROAD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 SOUTH AIRPORT RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62521",
            "telephone_number": "217-864-5912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAASCH",
        "first_name": "CALEB",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "IL",
            "license": "051303293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nichole L Bosserman
• Kathryn J Bourne
• Elias Bousheh
• Mackenzie Marie Bowers, APRN
• David M. Bozarth, RPH
• Kristina Kay Bradford, APN
• Elizabeth Bradley
• John G Bradley, M.D.
• Jonathan R Bradley, O.D.
• Brandon M. Piper, DMD, P.C.

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Decatur, IL
• Providers in Decatur, IL by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.