Brandon M Bott, PHARMD

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

051.303261 Issued in IL

Practice address

730 E Saginaw Hwy
Grand Ledge, MI 48837-8411

Phone

(517) 622-6810

NPI assigned

Oct 27, 2020

Last updated

Jun 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Meijer Inc

  dba Meijer Pharmacy #681

  • Community/Retail Pharmacy
  • Macomb, MI
  • NPI 1033833538
  NPD (past)
• Meijer Inc

  dba Meijer Pharmacy #210

  • Community/Retail Pharmacy
  • Grand Ledge, MI
  • NPI 1285773226
  NPD (past)

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1356941710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 E SAGINAW HWY",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488378411",
            "telephone_number": "517-622-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 E SAGINAW HWY",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488378411",
            "telephone_number": "517-622-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTT",
        "first_name": "BRANDON",
        "middle_name": "M",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-27",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302412671",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "051.303261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Marie Biergans, MS, MSN, RN, FNP-BC
• Kristy Blackmer, MA, LPC
• Maryann Blassingame
• Nicole Rene Boose
• Aleksandr Murray Borrello, LMT
• Anthony Matthew Bray
• Julie Brockway
• Brooks & Baum DDS PC
• David M Burnett, O.D.
• Taegan Amanda Byers, BS

• Athletic Trainer in Grand Ledge, MI
• Providers in Grand Ledge, MI by specialty
• Athletic Trainer in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.