Active NPI
Bryn Michael Nelson, PHARMD
- Pharmacist
- Moorefield, WV
National Provider Identifier
1114534336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP0011791
- Practice address
- 743 N Main St
Moorefield, WV 26836-1020 - Phone
- (435) 215-5883
- NPI assigned
- Oct 1, 2020
- 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 | RP0011791 | WV | Primary |
Addresses
Primary practice location
743 N Main St
Moorefield, WV 26836-1020
Mailing address
213 Robins Way
Woodstock, VA 22664-2084
Phone (435) 215-5883
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
| License | State | Type | Specialty |
|---|---|---|---|
| RP0011791 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601510400000",
"number": "1114534336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 ROBINS WAY",
"city": "WOODSTOCK",
"state": "VA",
"postal_code": "226642084",
"telephone_number": "435-215-5883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "743 N MAIN ST",
"city": "MOOREFIELD",
"state": "WV",
"postal_code": "268361020",
"telephone_number": "435-215-5883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "BRYN",
"middle_name": "MICHAEL",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-01",
"last_updated": "2020-10-01",
"certification_date": "2020-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0011791",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moorefield, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.