Active NPI
Brian Matthew Hodges, PHARMD
- Pharmacotherapy Pharmacist
- Charleston, WV
National Provider Identifier
1205023991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 6002
- Practice address
- 5300 Maccorkle Ave SE
Room 1-SD38
Charleston, WV 25304-2222 - Phone
- (304) 388-9717
- NPI assigned
- Sep 27, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6002 | WV | |
| Nutrition Support Pharmacist | 1835N1003X | 6002 | WV | |
| Pharmacotherapy Pharmacist | 1835P1200X | 6002 | WV | Primary |
Addresses
Primary practice location
5300 Maccorkle Ave SE
Room 1-SD38
Charleston, WV 25304-2222
Mailing address
5300 Maccorkle Ave SE
Room 1-SD38
Charleston, WV 25304-2222
Phone (304) 388-9717
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6002 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190851200000",
"number": "1205023991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 MACCORKLE AVE SE",
"address_2": "ROOM 1-SD38",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253042222",
"telephone_number": "304-388-9717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5300 MACCORKLE AVE SE",
"address_2": "ROOM 1-SD38",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253042222",
"telephone_number": "304-388-9717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGES",
"first_name": "BRIAN",
"middle_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-27",
"last_updated": "2007-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "6002",
"primary": false
},
{
"code": "1835N1003X",
"taxonomy_group": "",
"desc": "Pharmacist, Nutrition Support",
"state": "WV",
"license": "6002",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "WV",
"license": "6002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.