Active NPI
Matthew David Brooks, PHARMD
- Pharmacist
- Louisville, KY
National Provider Identifier
1467734392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 015079
- Practice address
- 3421 W Broadway
Louisville, KY 40211-2872 - Phone
- (502) 776-2528
- NPI assigned
- Sep 16, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 015079 | KY | Primary |
Addresses
Primary practice location
3421 W Broadway
Louisville, KY 40211-2872
Mailing address
126 Heady Ave
Louisville, KY 40207-3916
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
| License | State | Type | Specialty |
|---|---|---|---|
| 015079 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316131200000",
"number": "1467734392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 HEADY AVE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402073916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3421 W BROADWAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402112872",
"telephone_number": "502-776-2528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "MATTHEW",
"middle_name": "DAVID",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-16",
"last_updated": "2011-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "015079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.