Active NPI
Brad Alan Wolzak
- Pharmacist
- Independence, MO
National Provider Identifier
1184921223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 043944
- Practice address
- 4201 S Noland Rd
Independence, MO 64055-7313 - Phone
- (816) 478-3088
- Fax
- (816) 478-1623
- NPI assigned
- Feb 25, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 043944 | MO | Primary |
Addresses
Primary practice location
4201 S Noland Rd
Independence, MO 64055-7313
Mailing address
4201 S Noland Rd
Independence, MO 64055-7313
Phone (816) 478-3088
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 |
|---|---|---|---|
| 043944 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298592000000",
"number": "1184921223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 S NOLAND RD",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640557313",
"telephone_number": "816-478-3088",
"fax_number": "816-478-1623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 S NOLAND RD",
"city": "INDEPENDENCE",
"state": "MO",
"postal_code": "640557313",
"telephone_number": "816-478-3088",
"fax_number": "816-478-1623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLZAK",
"first_name": "BRAD",
"middle_name": "ALAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-25",
"last_updated": "2011-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "043944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Independence, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.