Individual provider Active NPI

Braxton Crawford

  • Pharmacist
  • Monroe, LA
National Provider Identifier
1487313599
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
024115 Issued in LA
Practice address
2123 Forsythe Ave
Monroe, LA 71201-3610
Phone
(318) 398-2100
NPI assigned
Dec 16, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 024115 LA Primary

Addresses

Primary practice location

2123 Forsythe Ave
Monroe, LA 71201-3610

Mailing address

102 Honesty LN
Monroe, LA 71203-6916
Phone (318) 820-1605

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

State licenses

LicenseStateTypeSpecialty
024115LAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1487313599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HONESTY LN",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712036916",
            "telephone_number": "318-820-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 FORSYTHE AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013610",
            "telephone_number": "318-398-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "BRAXTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "024115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.