Active NPI
Jimmy E Brantley
- Pharmacist
- Lafayette, LA
National Provider Identifier
1134401243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10333
- Practice address
- 705 Bertrand Dr
Lafayette, LA 70506-5546 - Phone
- (337) 232-7380
- Fax
- (337) 232-7791
- NPI assigned
- Sep 14, 2011
- 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 | 10333 | LA | Primary |
Addresses
Primary practice location
705 Bertrand Dr
Lafayette, LA 70506-5546
Mailing address
705 Bertrand Dr
Lafayette, LA 70506-5546
Phone (337) 232-7380
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 |
|---|---|---|---|
| 10333 | LA | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Louisiana CVS Pharmacy LLC | Past | Accepting new patients | |
| Louisiana CVS Pharmacy, L.L.C. | 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 and National Provider Directory roles.
-
- Pharmacy
- Mandeville, LA
- NPI 1619695848
-
- Pharmacy
- Lafayette, LA
- NPI 1154425064
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315958400000",
"number": "1134401243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 BERTRAND DR",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705065546",
"telephone_number": "337-232-7380",
"fax_number": "337-232-7791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 BERTRAND DR",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705065546",
"telephone_number": "337-232-7380",
"fax_number": "337-232-7791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANTLEY",
"first_name": "JIMMY",
"middle_name": "E",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-14",
"last_updated": "2011-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "10333",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.