Brianna Rae Peternell

Primary specialty

PharmacistTaxonomy code 183500000X

License

26028246A Issued in IN

Practice address

11115 W 133Rd Ave
Cedar Lake, IN 46303-9742

Phone

(219) 374-5688

NPI assigned

Nov 17, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hook-Superx LLC

  • Pharmacy
  • Cedar Lake, IN
  • NPI 1346343035
  NPD (past)

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1194328690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11115 W 133RD AVE",
            "city": "CEDAR LAKE",
            "state": "IN",
            "postal_code": "463039742",
            "telephone_number": "219-374-5688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11115 W 133RD AVE",
            "city": "CEDAR LAKE",
            "state": "IN",
            "postal_code": "463039742",
            "telephone_number": "219-374-5688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERNELL",
        "first_name": "BRIANNA",
        "middle_name": "RAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26028246A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Nichols
• Traci L Noble, MSW, LCSW
• Kathryn Oetting
• Daniel Osei-Bonsu, PHARMD MS RPH
• Margaret Parker, LCSW
• Robert Petersen
• Rehab Therapeutics, Inc
• Susan Russel
• Zubeyde Seda Sahin, PH.D.
• Theresa Lynn Sawaska, SLP-CCC

• Pharmacist in Cedar Lake, IN
• Providers in Cedar Lake, IN by specialty
• Pharmacist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.