Individual provider Active NPI

Brandon R Enghauser, PHARM. D.

  • Pharmacist
  • Florissant, MO
National Provider Identifier
1215701057
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2010026495 Issued in MO
Practice address
345 Dunn Rd
Florissant, MO 63031-7929
Phone
(314) 921-4242
NPI assigned
Nov 13, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051299330 IL
Pharmacist 183500000X PS54513 FL
Pharmacist 183500000X PH27546 MA
Pharmacist 183500000X 2010026495 MO Primary

Addresses

Primary practice location

345 Dunn Rd
Florissant, MO 63031-7929

Mailing address

345 Dunn Rd
Florissant, MO 63031-7929
Phone (314) 921-4242

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

LicenseStateTypeSpecialty
PS54513FLMDPharmacist
051299330ILMDPharmacist
PH27546MAMDPharmacist
2010026495MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Interlock Pharmacy Systems, LLC PastSince Nov 19, 2023 Accepting new patients

Organizations & group practices 1

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": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1215701057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 DUNN RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630317929",
            "telephone_number": "314-921-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 DUNN RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630317929",
            "telephone_number": "314-921-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGHAUSER",
        "first_name": "BRANDON",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051299330",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS54513",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH27546",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2010026495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.