Active NPI
Brian E Russell, PHARMD
- Pharmacist
- Henderson, KY
National Provider Identifier
1477154870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051296811
- Practice address
- 1195 Barrett Blvd Unit 2
Henderson, KY 42420-7508 - Phone
- (270) 826-6036
- NPI assigned
- Nov 3, 2020
- Last updated
- Nov 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 051296811 | IL | Primary |
Addresses
Primary practice location
1195 Barrett Blvd Unit 2
Henderson, KY 42420-7508
Mailing address
2111 Pebble Beach Dr
Newburgh, IN 47630-8415
Phone (618) 920-3460
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 |
|---|---|---|---|
| 051296811 | IL | MD | Pharmacist |
NPI Registry JSON
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": "1477154870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2111 PEBBLE BEACH DR",
"city": "NEWBURGH",
"state": "IN",
"postal_code": "476308415",
"telephone_number": "618-920-3460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1195 BARRETT BLVD UNIT 2",
"city": "HENDERSON",
"state": "KY",
"postal_code": "424207508",
"telephone_number": "270-826-6036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "BRIAN",
"middle_name": "E",
"credential": "PHARMD",
"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": "IL",
"license": "051296811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, KY
Sources for this page
- 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.