Individual provider Active NPI

Mitchell Tucker Brown, PHARMD

  • Pharmacist
  • Elizabeth City, NC
National Provider Identifier
1376826255
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16796 Issued in NC
Practice address
1141 N Road St
Suite A1
Elizabeth City, NC 27909-3354
Phone
(252) 331-1333
Fax
(252) 331-1911
NPI assigned
Sep 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16796 NC Primary

Addresses

Primary practice location

1141 N Road St
Suite A1
Elizabeth City, NC 27909-3354

Mailing address

1141 N Road St
Suite A1
Elizabeth City, NC 27909-3354
Phone (252) 331-1333

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

Practice roles

OrganizationSpecialtyStatusNew patients
Todds Northside Professional Pharmacy,Inc. Past Accepting new patients
Todds Northside Professional Pchy 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1376826255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 N ROAD ST",
            "address_2": "SUITE A1",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093354",
            "telephone_number": "252-331-1333",
            "fax_number": "252-331-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 N ROAD ST",
            "address_2": "SUITE A1",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093354",
            "telephone_number": "252-331-1333",
            "fax_number": "252-331-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MITCHELL",
        "middle_name": "TUCKER",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "16796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth City, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.