Individual provider Active NPI

Jennifer M Brackett, PHARM D

  • Pharmacist
  • Ellsworth, ME
National Provider Identifier
1396112140
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PR45340 Issued in ME
Practice address
226 High St
Ellsworth, ME 04605-1742
Phone
(207) 664-0952
Fax
(207) 664-0958
NPI assigned
Aug 27, 2015
Sex
Female
Sole proprietor
No

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

LicenseStateTypeSpecialty
PR45340MEMDPharmacist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PR45340 ME Primary

Addresses

NPPES NPI Registry

Primary practice location

226 High St
Ellsworth, ME 04605-1742

Mailing address

226 High St
Ellsworth, ME 04605-1742
Phone (207) 664-0952

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 27, 2015.

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1396112140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 HIGH ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051742",
            "telephone_number": "207-664-0952",
            "fax_number": "207-664-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 HIGH ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051742",
            "telephone_number": "207-664-0952",
            "fax_number": "207-664-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKETT",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR45340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.