Individual provider Active NPI

Brett Bolden

  • Pharmacist
  • Chelsea, AL
National Provider Identifier
1205433117
Registry record updated Oct 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15958 Issued in AL
Practice address
15582 Highway 280
Chelsea, AL 35043-8360
Phone
(205) 678-3899
NPI assigned
Oct 4, 2020
Last updated
Oct 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15958 AL Primary

Addresses

Primary practice location

15582 Highway 280
Chelsea, AL 35043-8360

Mailing address

3409 Laurel View LN
Vestavia Hills, AL 35216-3853

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL npi Health Information Exchange (HIE)

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

LicenseStateTypeSpecialty
15958ALMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1601769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601769600000",
    "number": "1205433117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 LAUREL VIEW LN",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352163853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15582 HIGHWAY 280",
            "city": "CHELSEA",
            "state": "AL",
            "postal_code": "350438360",
            "telephone_number": "205-678-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "BRETT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-04",
        "last_updated": "2020-10-04",
        "certification_date": "2020-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "15958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "npi",
            "affiliation": "N",
            "endpointDescription": "npi",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "15582 Highway 280",
            "city": "Chelsea",
            "state": "AL",
            "country_code": "US",
            "postal_code": "350438360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chelsea, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.