Active NPI
Brandon Edwards, PHARMD
- Pharmacist
- Normal, IL
National Provider Identifier
1306195953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051296064
- Practice address
- 901 S Cottage Ave
Normal, IL 61761 - Phone
- (309) 454-8768
- NPI assigned
- Aug 29, 2012
- Sex
- Male
- 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 | 051296064 | IL | Primary |
Addresses
Primary practice location
901 S Cottage Ave
Normal, IL 61761
Mailing address
1108 Ekstam Dr.
Apt 3
Bloomington, IL 61704
Phone (618) 550-7452
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
| License | State | Type | Specialty |
|---|---|---|---|
| 051296064 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1306195953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 EKSTAM DR.",
"address_2": "APT 3",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "61704",
"telephone_number": "618-550-7452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 S COTTAGE AVE",
"city": "NORMAL",
"state": "IL",
"postal_code": "61761",
"telephone_number": "309-454-8768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "BRANDON",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-29",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051296064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.