Active NPI
Scott Bragg
- Pharmacist
- Youngstown, OH
National Provider Identifier
1205211828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03334519
- Practice address
- 4475 Mahoning Ave
Youngstown, OH 44515-1602 - Phone
- (330) 793-2429
- NPI assigned
- Jul 24, 2015
- Last updated
- Jul 24, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03334519 | OH | Primary |
Addresses
Primary practice location
4475 Mahoning Ave
Youngstown, OH 44515-1602
Mailing address
4475 Mahoning Ave
Youngstown, OH 44515-1602
Phone (330) 793-2429
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 |
|---|---|---|---|
| 03334519 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437696000000",
"number": "1205211828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4475 MAHONING AVE",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445151602",
"telephone_number": "330-793-2429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4475 MAHONING AVE",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445151602",
"telephone_number": "330-793-2429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAGG",
"first_name": "SCOTT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-24",
"last_updated": "2015-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03334519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.