Active NPI
Brett Garland Perlberg
- Pharmacist
- Scott AFB, IL
National Provider Identifier
1366636227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03230462-2
- Practice address
- 375TH Medical Group
310 West Losey Street
Scott AFB, IL 62225 - Phone
- (618) 256-7345
- NPI assigned
- Sep 4, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2014012581 | MO | |
| Pharmacist | 183500000X | 03230462-2 | OH | Primary |
Addresses
Primary practice location
375TH Medical Group
310 West Losey Street
Scott AFB, IL 62225
Mailing address
375TH Medical Group
310 West Losey Street
Scott AFB, IL 62225
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014012581 | MO | MD | Pharmacist |
| 03230462-2 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524182400000",
"number": "1366636227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375TH MEDICAL GROUP",
"address_2": "310 WEST LOSEY STREET",
"city": "SCOTT AFB",
"state": "IL",
"postal_code": "62225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375TH MEDICAL GROUP",
"address_2": "310 WEST LOSEY STREET",
"city": "SCOTT AFB",
"state": "IL",
"postal_code": "62225",
"telephone_number": "618-256-7345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERLBERG",
"first_name": "BRETT",
"middle_name": "GARLAND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-04",
"last_updated": "2018-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2014012581",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03230462-2",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scott AFB, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.