Individual provider Active NPI

Daniel R Barra

  • Pharmacist
  • Bangor, ME
National Provider Identifier
1407379357
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PR69356 Issued in ME
Practice address
1012 Union St
Bangor, ME 04401-3060
Phone
(207) 992-4100
NPI assigned
Jul 24, 2017
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X ME
Pharmacist 183500000X S024554 AZ
Pharmacist 183500000X PR69356 ME Primary

Addresses

Primary practice location

1012 Union St
Bangor, ME 04401-3060

Mailing address

1031 Main St
Veazie, ME 04401-7011
Phone (207) 251-6416

Other practice location 1

1031 Main St
Veazie, ME 04401-7011
Phone (207) 251-6416

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

State licenses

LicenseStateTypeSpecialty
S024554AZMDPharmacist
PR69356MEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1407379357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 MAIN ST",
            "city": "VEAZIE",
            "state": "ME",
            "postal_code": "044017011",
            "telephone_number": "207-251-6416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 UNION ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013060",
            "telephone_number": "207-992-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1031 Main St",
            "address_purpose": "LOCATION",
            "city": "Veazie",
            "state": "ME",
            "postal_code": "044017011",
            "country_code": "US",
            "telephone_number": "207-251-6416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARRA",
        "first_name": "DANIEL",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-24",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ME",
            "license": null,
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S024554",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR69356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.