Individual provider Active NPI

Jacob Brown

  • Pharmacotherapy Pharmacist
  • Duluth, MN
National Provider Identifier
1073067757
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
122241 Issued in MN
Practice address
31 W 1St St
Duluth, MN 55802-2003
Phone
(218) 727-4200
Fax
(218) 727-4559
NPI assigned
Aug 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 122241 MN Primary

Addresses

Primary practice location

31 W 1St St
Duluth, MN 55802-2003

Mailing address

1401 E 1St St
Duluth, MN 55805-2407
Phone (218) 728-4491

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

State licenses

LicenseStateTypeSpecialty
122241MNMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1073067757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052407",
            "telephone_number": "218-728-4491",
            "fax_number": "218-730-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022003",
            "telephone_number": "218-727-4200",
            "fax_number": "218-727-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MN",
            "license": "122241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.