Individual provider Active NPI

Jacob Milbradt, PHARMD

  • Pharmacist
  • El Dorado, KS
National Provider Identifier
1316538457
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
1-13502 Issued in KS
Practice address
205 N Vine St
El Dorado, KS 67042-2055
Phone
(316) 321-5330
Fax
(316) 321-1254
NPI assigned
Feb 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 1-13502 KS Primary

Addresses

Primary practice location

205 N Vine St
El Dorado, KS 67042-2055

Mailing address

205 N Vine St
El Dorado, KS 67042-2055
Phone (316) 321-5330

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

LicenseStateTypeSpecialty
1-13502KSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
El Dorado Pharmacy Inc CurrentSince Jul 24, 2022 Accepting new patients
El Dorado Pharmacy Inc PastSince Feb 7, 2021 Accepting new patients

Locations

205 N Vine St
El Dorado, KS 67042
Phone (316) 321-5330

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1316538457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N VINE ST",
            "city": "EL DORADO",
            "state": "KS",
            "postal_code": "670422055",
            "telephone_number": "316-321-5330",
            "fax_number": "316-321-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N VINE ST",
            "city": "EL DORADO",
            "state": "KS",
            "postal_code": "670422055",
            "telephone_number": "316-321-5330",
            "fax_number": "316-321-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILBRADT",
        "first_name": "JACOB",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-13502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.