Individual provider Active NPI

Jerome R Brite III, PHARM D.

  • Pharmacist
  • Snellville, GA
National Provider Identifier
1124313812
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
020385 Issued in GA
Practice address
1905 Scenic Hwy N
Target-0917
Snellville, GA 30078-5633
Phone
(678) 344-8223
Fax
(678) 344-8223
NPI assigned
Jun 10, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 020385 GA Primary

Addresses

Primary practice location

1905 Scenic Hwy N
Target-0917
Snellville, GA 30078-5633

Mailing address

1905 Scenic Hwy N
Target-0917
Snellville, GA 30078-5633
Phone (678) 344-8223

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

LicenseStateTypeSpecialty
020385GAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina CVS Pharmacy LLC Past Accepting new patients

Organizations & group practices 1

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": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1124313812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 SCENIC HWY N",
            "address_2": "TARGET-0917",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785633",
            "telephone_number": "678-344-8223",
            "fax_number": "678-344-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 SCENIC HWY N",
            "address_2": "TARGET-0917",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785633",
            "telephone_number": "678-344-8223",
            "fax_number": "678-344-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRITE",
        "first_name": "JEROME",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PHARM D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "020385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; 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.