Active NPI
Recennah Dalevetta Braxton, PHARM.D
- Pharmacist
- Greenville, AL
National Provider Identifier
1508096371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16369
- Practice address
- 101 Greenville Byp
Greenville, AL 36037-3724 - Phone
- (334) 202-4003
- NPI assigned
- Jul 15, 2009
- Last updated
- Sep 26, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202209288 | VA | |
| Pharmacist | 183500000X | 16369 | AL | Primary |
| Pharmacist | 183500000X | 2009025144 | MO |
Addresses
Primary practice location
101 Greenville Byp
Greenville, AL 36037-3724
Mailing address
6604 Rock Ledge Rd
Montgomery, AL 36117-7683
Phone (334) 202-4003
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 |
|---|---|---|---|
| 2009025144 | MO | MD | Pharmacist |
| 0202209288 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316995200000",
"number": "1508096371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6604 ROCK LEDGE RD",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361177683",
"telephone_number": "334-202-4003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 GREENVILLE BYP",
"city": "GREENVILLE",
"state": "AL",
"postal_code": "360373724",
"telephone_number": "334-202-4003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAXTON",
"first_name": "RECENNAH",
"middle_name": "DALEVETTA",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-15",
"last_updated": "2011-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202209288",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "16369",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2009025144",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.