Individual provider Active NPI

Brian K Gellenbeck

  • Pharmacist
  • Phoenix, AZ
National Provider Identifier
1144640939
Registry record updated Apr 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S018862 Issued in AZ
Practice address
3975 E Thunderbird Rd
Phoenix, AZ 85032-5711
Phone
(602) 923-0891
Fax
(602) 923-0415
NPI assigned
Apr 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S018862 AZ Primary

Addresses

Primary practice location

3975 E Thunderbird Rd
Phoenix, AZ 85032-5711

Mailing address

3975 E Thunderbird Rd
Phoenix, AZ 85032-5711
Phone (602) 923-0891

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
S018862AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
German Dobson CVS LLC Past Accepting new patients
German Dobson CVS LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398038400000",
    "number": "1144640939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 E THUNDERBIRD RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850325711",
            "telephone_number": "602-923-0891",
            "fax_number": "602-923-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 E THUNDERBIRD RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850325711",
            "telephone_number": "602-923-0891",
            "fax_number": "602-923-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELLENBECK",
        "first_name": "BRIAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-21",
        "last_updated": "2014-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S018862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; 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.