Active NPI
Jacob Brian Braunschneider
- Pharmacist
- Red Lake, MN
National Provider Identifier
1588491963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302416628
- Practice address
- 24760 Hospital Drive
Red Lake, MN 56671 - Phone
- (218) 679-2825
- NPI assigned
- Sep 18, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS67728 | FL | |
| Pharmacist | 183500000X | 5302416628 | MI | Primary |
Addresses
Primary practice location
24760 Hospital Drive
Red Lake, MN 56671
Mailing address
710 38TH St NW
Bemidji, MN 56601-2297
Phone (586) 899-4722
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS67728 | FL | MD | Pharmacist |
| 5302416628 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738195200000",
"number": "1588491963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 38TH ST NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566012297",
"telephone_number": "586-899-4722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24760 HOSPITAL DRIVE",
"city": "RED LAKE",
"state": "MN",
"postal_code": "56671",
"telephone_number": "218-679-2825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAUNSCHNEIDER",
"first_name": "JACOB",
"middle_name": "BRIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-18",
"last_updated": "2025-01-30",
"certification_date": "2025-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS67728",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302416628",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Red Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.