NPIMap

Individual provider Active NPI

Reagan Brown

  • Pharmacist
  • Crystal Springs, MS
National Provider Identifier
1295299501
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E-08321 Issued in MS
Practice address
113 Bo Bo Dr
Crystal Springs, MS 39059-2741
Phone
(601) 892-4121
Fax
(601) 892-1598
NPI assigned
Jan 31, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E-08321 MS Primary

Addresses

Primary practice location

113 Bo Bo Dr
Crystal Springs, MS 39059-2741

Mailing address

120 Limestone CV
Terry, MS 39170-8573
Phone (601) 259-8032

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
E-08321MSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
City Drug 2, LLC Current Accepting new patients
City Drug, LLC Current Accepting new patients
City Drugs of Crystal Springs, Inc. Past Accepting new patients

Locations

113 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-4121

Organizations & group practices 3

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": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1295299501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 LIMESTONE CV",
            "city": "TERRY",
            "state": "MS",
            "postal_code": "391708573",
            "telephone_number": "601-259-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 BO BO DR",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592741",
            "telephone_number": "601-892-4121",
            "fax_number": "601-892-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "REAGAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-08321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Springs, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.