Individual provider Active NPI

Cassandra Brockelman, PHARMD

  • Pharmacotherapy Pharmacist
  • Clinton, OK
National Provider Identifier
1497944102
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
14002 Issued in OK
Practice address
RR 1 Box 3060
Clinton, OK 73601-9303
Phone
(580) 331-3351
Fax
(580) 331-3555
NPI assigned
Oct 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 14002 OK Primary

Addresses

Primary practice location

RR 1 Box 3060
Clinton, OK 73601-9303

Mailing address

2105 Morgandee LN
Weatherford, OK 73096-2949
Phone (580) 331-3351

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
14002OKMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1497944102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 MORGANDEE LN",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730962949",
            "telephone_number": "580-331-3351",
            "fax_number": "580-331-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 3060",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736019303",
            "telephone_number": "580-331-3351",
            "fax_number": "580-331-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKELMAN",
        "first_name": "CASSANDRA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "OK",
            "license": "14002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.