Active NPI
Brian Thomas McDonough, RPH
- Pharmacist
- Gary, IN
National Provider Identifier
1326238700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26017473A
- Practice address
- 805 S Lake St
Gary, IN 46403-2918 - Phone
- (219) 938-4857
- Fax
- (219) 938-4809
- NPI assigned
- Jul 31, 2007
- 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 | 26017473A | IN | Primary |
Addresses
Primary practice location
805 S Lake St
Gary, IN 46403-2918
Mailing address
12705 Morning Dove Dr
Cedar Lake, IN 46303-8607
Phone (219) 374-8824
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26017473A | IN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185840000000",
"number": "1326238700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12705 MORNING DOVE DR",
"city": "CEDAR LAKE",
"state": "IN",
"postal_code": "463038607",
"telephone_number": "219-374-8824",
"fax_number": "219-374-8824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 S LAKE ST",
"city": "GARY",
"state": "IN",
"postal_code": "464032918",
"telephone_number": "219-938-4857",
"fax_number": "219-938-4809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONOUGH",
"first_name": "BRIAN",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-31",
"last_updated": "2007-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26017473A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gary, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.