Active NPI
Brian Joseph Autry, PHARMD, MPH
- Pharmacist
- Madison, WI
National Provider Identifier
1336828391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21067
- Practice address
- 600 Highland Ave
Madison, WI 53792-0001 - Phone
- (608) 263-6400
- NPI assigned
- Jul 17, 2023
- 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 | 21067 | WI | Primary |
Addresses
Primary practice location
600 Highland Ave
Madison, WI 53792-0001
Mailing address
4250 University Ave Apt 301
Madison, WI 53705-2147
Phone (515) 314-4176
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 |
|---|---|---|---|
| 21067 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689552000000",
"number": "1336828391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4250 UNIVERSITY AVE APT 301",
"city": "MADISON",
"state": "WI",
"postal_code": "537052147",
"telephone_number": "515-314-4176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE",
"city": "MADISON",
"state": "WI",
"postal_code": "537920001",
"telephone_number": "608-263-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUTRY",
"first_name": "BRIAN",
"middle_name": "JOSEPH",
"credential": "PHARMD, MPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-07-17",
"last_updated": "2023-07-17",
"certification_date": "2023-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "WI",
"license": "21067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
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- Walter John Austin, C. PED
- Authentic Healing LLC
- Autism Society of South Central Wisconsin
- Autism Spectrum Therapies of Delaware, LLC (Wisconsin Early Autism Project)
- Avail Therapeutic Services LLC
- Dezarae Avalos
- Velma G Avalos
- Avandra Mental Wellness LLC
- Avenues to Community Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.