Individual provider Active NPI

Brett Joseph Albert Marryshow, PHARMD

  • Pharmacist
  • Henderson, NV
National Provider Identifier
1336588391
Registry record updated Jun 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18016 Issued in NV
Practice address
2851 N Green Valley Pkwy
Henderson, NV 89014-0402
Phone
(702) 435-9849
Fax
(702) 435-8520
NPI assigned
Jun 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18016 NV Primary
Pharmacist 183500000X 015027 KY

Addresses

Primary practice location

2851 N Green Valley Pkwy
Henderson, NV 89014-0402

Mailing address

2851 N Green Valley Pkwy
Henderson, NV 89014-0402
Phone (702) 435-9849

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
015027KYMDPharmacist
18016NVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1371859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371859200000",
    "number": "1336588391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 N GREEN VALLEY PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890140402",
            "telephone_number": "702-435-9849",
            "fax_number": "702-435-8520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 N GREEN VALLEY PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890140402",
            "telephone_number": "702-435-9849",
            "fax_number": "702-435-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRYSHOW",
        "first_name": "BRETT",
        "middle_name": "JOSEPH ALBERT",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-22",
        "last_updated": "2013-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "18016",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "015027",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2013; 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.