NPIMap

Individual provider Active NPI

Brooke Lauren Kordsmeier, PHARM D

  • Pharmacist
  • Conway, AR
National Provider Identifier
1447896584
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PD12797 Issued in AR
Practice address
855 Salem Rd
Conway, AR 72034-4820
Phone
(501) 329-3981
NPI assigned
Nov 25, 2019
Last updated
Nov 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD12797 AR Primary

Addresses

Primary practice location

855 Salem Rd
Conway, AR 72034-4820

Mailing address

855 Salem Rd
Conway, AR 72034-4820
Phone (501) 329-3981

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

LicenseStateTypeSpecialty
PD12797ARMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I PastSince Dec 1, 2019 Accepting new patients
Kroger Limited Partnership I PastSince Dec 1, 2019 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": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1447896584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 SALEM RD",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344820",
            "telephone_number": "501-329-3981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 SALEM RD",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720344820",
            "telephone_number": "501-329-3981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORDSMEIER",
        "first_name": "BROOKE",
        "middle_name": "LAUREN",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD12797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.