Active NPI
Brenda Ellis, PHARMD
- Pharmacist
- Boone, NC
National Provider Identifier
1396334546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14084
- Practice address
- 345 Deerfield Rd
Boone, NC 28607-5009 - Phone
- (828) 264-3055
- NPI assigned
- Jan 12, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14084 | NC | Primary |
Addresses
Primary practice location
345 Deerfield Rd
Boone, NC 28607-5009
Mailing address
306 Parkway Village Dr
Boone, NC 28607-7167
Phone (828) 832-6044
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 |
|---|---|---|---|
| 14084 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610409600000",
"number": "1396334546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 PARKWAY VILLAGE DR",
"city": "BOONE",
"state": "NC",
"postal_code": "286077167",
"telephone_number": "828-832-6044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 DEERFIELD RD",
"city": "BOONE",
"state": "NC",
"postal_code": "286075009",
"telephone_number": "828-264-3055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "BRENDA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-12",
"last_updated": "2021-01-12",
"certification_date": "2021-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "14084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boone, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.