Active NPI
Brooke Bennett
- Pharmacist
- Dubuque, IA
National Provider Identifier
1265913115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 23444
- Practice address
- 1920 Elm St
Dubuque, IA 52001-3641 - Phone
- (563) 583-7379
- NPI assigned
- Aug 28, 2018
- Last updated
- Aug 28, 2018
- Sex
- Female
- 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 | 23444 | IA | Primary |
Addresses
Primary practice location
1920 Elm St
Dubuque, IA 52001-3641
Mailing address
2821 Jefferson Ave
Davenport, IA 52803-1605
Phone (515) 368-0474
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23444 | Other | IA | NATIONAL ASSOCIATION OF BOARDS OF PHARMACY (NABP) |
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 |
|---|---|---|---|
| 23444 | IA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Family Pharmacy | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535414400000",
"number": "1265913115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2821 JEFFERSON AVE",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528031605",
"telephone_number": "515-368-0474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1920 ELM ST",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520013641",
"telephone_number": "563-583-7379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "BROOKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-28",
"last_updated": "2018-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "23444",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL ASSOCIATION OF BOARDS OF PHARMACY (NABP)",
"identifier": "23444",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dubuque, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.