Active NPI
Brent Michael Cantrelle, PHARMD
- Pharmacist
- Cut Off, LA
National Provider Identifier
1316228919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 018704
- Practice address
- 16804 W Main St
Cut Off, LA 70345-4004 - Phone
- (985) 632-6774
- Fax
- (985) 632-7341
- NPI assigned
- Sep 9, 2011
- Last updated
- Sep 9, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 018704 | LA | Primary |
Addresses
Primary practice location
16804 W Main St
Cut Off, LA 70345-4004
Mailing address
16804 W Main St
Cut Off, LA 70345-4004
Phone (985) 632-6774
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2123793 | Medicaid | LA |
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 |
|---|---|---|---|
| 018704 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Louisiana CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Louisiana CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 2
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": "1315526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315526400000",
"number": "1316228919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16804 W MAIN ST",
"city": "CUT OFF",
"state": "LA",
"postal_code": "703454004",
"telephone_number": "985-632-6774",
"fax_number": "985-632-7341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16804 W MAIN ST",
"city": "CUT OFF",
"state": "LA",
"postal_code": "703454004",
"telephone_number": "985-632-6774",
"fax_number": "985-632-7341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANTRELLE",
"first_name": "BRENT",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-09",
"last_updated": "2011-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "018704",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2123793",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cut Off, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.