Tyler Justin Brakke, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

24166 Issued in IA

Practice address

2216 Main St
Emmetsburg, IA 50536-2447

Phone

(712) 852-2886

NPI assigned

Jul 23, 2021

Last updated

Nov 20, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637366400000",
    "number": "1295308500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 SUNSET CIR",
            "city": "EMMETSBURG",
            "state": "IA",
            "postal_code": "505361076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 MAIN ST",
            "city": "EMMETSBURG",
            "state": "IA",
            "postal_code": "505362447",
            "telephone_number": "712-852-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAKKE",
        "first_name": "TYLER",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-11-20",
        "certification_date": "2021-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "24166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "HIM@pamhn.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Palo Alto County Health System Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2216 Main St",
            "city": "Emmetsburg",
            "state": "IA",
            "country_code": "US",
            "postal_code": "505362447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Beardsley, R.PH
• Amanda Kristine Beurskens, ARNP-BC
• James Lester Bird, D.C.
• Paula Jane Blocker, LICSW
• Sara Boysen, ARNP
• Jennifer Veronica Coppage, R.PH.
• Shelby Cronk, MS
• Tami June Culver, PTA
• Siobhan Danreis, LMHC
• Dean Ver Mulm, OD PC

• Pharmacist in Emmetsburg, IA
• Providers in Emmetsburg, IA by specialty
• Pharmacist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2021; 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.