Active NPI
Brock T Bates
- Pharmacist
- Ogden, UT
National Provider Identifier
1083963755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6299233-1701
- Practice address
- 255 36TH St
Ogden, UT 84405-7120 - Phone
- (801) 689-1358
- Fax
- (801) 689-1361
- NPI assigned
- Sep 10, 2012
- Last updated
- Dec 19, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6299233-1701 | UT | Primary |
Addresses
Primary practice location
255 36TH St
Ogden, UT 84405-7120
Mailing address
860 N Fairfield Rd
Layton, UT 84041-2725
Phone (801) 546-6352
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6299233-1701 | UT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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": "1347235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671408000000",
"number": "1083963755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "860 N FAIRFIELD RD",
"city": "LAYTON",
"state": "UT",
"postal_code": "840412725",
"telephone_number": "801-546-6352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 36TH ST",
"city": "OGDEN",
"state": "UT",
"postal_code": "844057120",
"telephone_number": "801-689-1358",
"fax_number": "801-689-1361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BATES",
"first_name": "BROCK",
"middle_name": "T",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-10",
"last_updated": "2022-12-19",
"certification_date": "2022-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "6299233-1701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.