Brent D Herron

Primary specialty

PharmacistTaxonomy code 183500000X

License

051302607 Issued in IL

Practice address

2610 N Prospect Ave
Champaign, IL 61822-1251

Phone

(217) 352-1490

Fax

(317) 352-1490

NPI assigned

Nov 3, 2020

Last updated

Nov 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1427659820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 N PROSPECT AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221251",
            "telephone_number": "217-352-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 N PROSPECT AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221251",
            "telephone_number": "217-352-1490",
            "fax_number": "317-352-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON",
        "first_name": "BRENT",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26023781A",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051302607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "162420",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Walmart",
            "affiliation": "N",
            "endpointDescription": "Walmart",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2610 N Prospect Ave",
            "city": "Champaign",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618221251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Ann Hensold, MSW
• Jacqueline Henson, RBT
• Emma Henss, RBT
• Simone Herbert, LCSW
• Samantha Herriott, PT
• Brandi Hertel, OTR/L
• Amanda N Herzog
• Andrea Jennifer Herzog, MSW
• Matthew D Hesch, DPT
• Jerry L. Heselton, P.T.

• Pharmacist in Champaign, IL
• Providers in Champaign, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; 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.