Active NPI
Brody Olson, RPH
- Pharmacist
- Coeur d'Alene, ID
National Provider Identifier
1437523651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P7406
- Practice address
- 335 W Appleway Ave
Coeur D Alene, ID 83814-9306 - Phone
- (208) 765-1254
- NPI assigned
- Nov 26, 2015
- Last updated
- Nov 26, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P7406 | ID | Primary |
| Pharmacist | 183500000X | 18082-40 | WI |
Addresses
Primary practice location
335 W Appleway Ave
Coeur D Alene, ID 83814-9306
Mailing address
4821 Schneider Dr
Fitchburg, WI 53575-2231
Phone (909) 499-7861
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P7406 | ID | MD | Pharmacist |
| 18082-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448496000000",
"number": "1437523651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4821 SCHNEIDER DR",
"city": "FITCHBURG",
"state": "WI",
"postal_code": "535752231",
"telephone_number": "909-499-7861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 W APPLEWAY AVE",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838149306",
"telephone_number": "208-765-1254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "BRODY",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-26",
"last_updated": "2015-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P7406",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "18082-40",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coeur d'Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.