NPIMap

Individual provider Active NPI

Adam Brunelle

  • Pharmacist
  • Mesa, AZ
National Provider Identifier
1215216841
Registry record updated Aug 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S018503 Issued in AZ
Practice address
4440 E Main St
Mesa, AZ 85205-7902
Phone
(480) 218-8573
NPI assigned
Aug 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S018503 AZ Primary

Addresses

Primary practice location

4440 E Main St
Mesa, AZ 85205-7902

Mailing address

2093 E Marlene Dr
Gilbert, AZ 85296-1523
Phone (623) 210-3378

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
S018503AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Smith'S Food & Drug Centers Inc Past Accepting new patients
Smiths Food & Drug Centers Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1313193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313193600000",
    "number": "1215216841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2093 E MARLENE DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961523",
            "telephone_number": "623-210-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 E MAIN ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852057902",
            "telephone_number": "480-218-8573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNELLE",
        "first_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-13",
        "last_updated": "2011-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S018503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.

Verify at the official NPI Registry.