Active NPI
Brian Keith Braegger, PHARM.D
- Pharmacist
- Herriman, UT
National Provider Identifier
1366773111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4753323-1701
- Practice address
- 14029 S Ivie Rose CT
Herriman, UT 84096-4719 - Phone
- (801) 592-2381
- NPI assigned
- Jan 19, 2010
- Last updated
- Jul 29, 2022
- 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 | S013723 | AZ | |
| Pharmacist | 183500000X | 4753323-1701 | UT | Primary |
Addresses
Primary practice location
14029 S Ivie Rose CT
Herriman, UT 84096-4719
Mailing address
14029 S Ivie Rose CT
Herriman, UT 84096-4719
Phone (801) 592-2381
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 |
|---|---|---|---|
| S013723 | AZ | MD | Pharmacist |
| 4753323-1701 | UT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659052800000",
"number": "1366773111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14029 S IVIE ROSE CT",
"city": "HERRIMAN",
"state": "UT",
"postal_code": "840964719",
"telephone_number": "801-592-2381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14029 S IVIE ROSE CT",
"city": "HERRIMAN",
"state": "UT",
"postal_code": "840964719",
"telephone_number": "801-592-2381"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAEGGER",
"first_name": "BRIAN",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-01-19",
"last_updated": "2022-07-29",
"certification_date": "2022-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S013723",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "4753323-1701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Herriman, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.