Individual provider Active NPI

Brent Small, BS

  • Pharmacist
  • Las Vegas, NV
National Provider Identifier
1407141708
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15372 Issued in NV
Practice address
6480 Sky Pointe Dr
T-1462
Las Vegas, NV 89131-4038
Phone
(702) 656-4791
Fax
(702) 656-4791
NPI assigned
Jun 14, 2011
Last updated
Jun 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 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 15372 NV Primary

Addresses

Primary practice location

6480 Sky Pointe Dr
T-1462
Las Vegas, NV 89131-4038

Mailing address

6480 Sky Pointe Dr
T-1462
Las Vegas, NV 89131-4038
Phone (702) 656-4791

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
Bachelor of Science

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1407141708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 SKY POINTE DR",
            "address_2": "T-1462",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891314038",
            "telephone_number": "702-656-4791",
            "fax_number": "702-656-4791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6480 SKY POINTE DR",
            "address_2": "T-1462",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891314038",
            "telephone_number": "702-656-4791",
            "fax_number": "702-656-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "BRENT",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "15372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.