NPIMap

Individual provider Active NPI

John Bradley Plunkett, R.PH.

  • Pharmacist
  • Indianapolis, IN
National Provider Identifier
1063758910
Registry record updated Dec 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26017674A Issued in IN
Practice address
342 Massachusetts Ave
Suite 103
Indianapolis, IN 46204-2146
Phone
(317) 631-6000
Fax
(317) 631-6004
NPI assigned
Dec 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26017674A IN Primary
Pharmacist 183500000X RPH026438 GA
Pharmacist 183500000X 120729 MN

Addresses

Primary practice location

342 Massachusetts Ave
Suite 103
Indianapolis, IN 46204-2146

Mailing address

342 Massachusetts Ave
Suite 103
Indianapolis, IN 46204-2146
Phone (317) 631-6000

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH026438GAMDPharmacist
26017674AINMDPharmacist
120729MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Damien Cares Inc. Current Accepting new patients
Damien Pharmacy, LLC Current Accepting new patients
Damien Pharmacy, LLC Current Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1356048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1063758910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 MASSACHUSETTS AVE",
            "address_2": "SUITE 103",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462042146",
            "telephone_number": "317-631-6000",
            "fax_number": "317-631-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 MASSACHUSETTS AVE",
            "address_2": "SUITE 103",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462042146",
            "telephone_number": "317-631-6000",
            "fax_number": "317-631-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUNKETT",
        "first_name": "JOHN",
        "middle_name": "BRADLEY",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-21",
        "last_updated": "2012-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26017674A",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH026438",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "120729",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; 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.