NPIMap

Individual provider Active NPI

Brenda A Jaworski, RPH

  • Pharmacist
  • Ironwood, MI
National Provider Identifier
1184834137
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14292-040 Issued in WI
Practice address
802 E Cloverland Dr
Ironwood, MI 49938-1502
Phone
(906) 932-4267
Fax
(906) 932-4609
NPI assigned
May 22, 2007
Last updated
Nov 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302410688 MI
Pharmacist 183500000X 14292-040 WI Primary

Addresses

Primary practice location

802 E Cloverland Dr
Ironwood, MI 49938-1502

Mailing address

130 Old US 2
Wakefield, MI 49968-9534
Phone (231) 429-5854

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rxm.11954@store.walgreens.com

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302410688MIMDPharmacist
14292-040WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Mar 27, 2022 Accepting new patients
Walgreen Co PastSince Nov 15, 2020 Accepting new patients

Locations

802 E Cloverland Dr
Ironwood, MI 49938
Phone (906) 932-4267

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1184834137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 OLD US 2",
            "city": "WAKEFIELD",
            "state": "MI",
            "postal_code": "499689534",
            "telephone_number": "231-429-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 E CLOVERLAND DR",
            "city": "IRONWOOD",
            "state": "MI",
            "postal_code": "499381502",
            "telephone_number": "906-932-4267",
            "fax_number": "906-932-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAWORSKI",
        "first_name": "BRENDA",
        "middle_name": "A",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302410688",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "14292-040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rxm.11954@store.walgreens.com",
            "affiliation": "N",
            "endpointDescription": "RXM email",
            "address_1": "802 E Cloverland Dr",
            "city": "Ironwood",
            "state": "MI",
            "country_code": "US",
            "postal_code": "499381502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ironwood, MI

Sources for this page

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

Verify at the official NPI Registry.