Active NPI
Mackenzie Ryann Broglie O'Shea, PHARMD
- Pharmacist
- Hampton, VA
National Provider Identifier
1598364796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202219190
- Practice address
- 919 W Mercury Blvd
Hampton, VA 23666-4322 - Phone
- (757) 827-2995
- NPI assigned
- Oct 20, 2020
- Last updated
- Oct 20, 2020
- Sex
- Female
- 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 | 0202219190 | VA | Primary |
Addresses
Primary practice location
919 W Mercury Blvd
Hampton, VA 23666-4322
Mailing address
401 Henley CT Apt E
Chesapeake, VA 23320-4967
Phone (757) 945-8455
Other names 1
- Mackenzie Ryann Juels
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 |
|---|---|---|---|
| 0202219190 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603152000000",
"number": "1598364796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 HENLEY CT APT E",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233204967",
"telephone_number": "757-945-8455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "919 W MERCURY BLVD",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236664322",
"telephone_number": "757-827-2995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'SHEA",
"first_name": "MACKENZIE",
"middle_name": "RYANN BROGLIE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-20",
"last_updated": "2020-10-20",
"certification_date": "2020-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202219190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MACKENZIE",
"last_name": "JUELS",
"middle_name": "RYANN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hampton, VA
- Jane Song Nzuna
- Jacqueline Ann O'Connell-Bagnati, LCSW
- Julia O'Handley, NURSE AID
- Maritza O'Neal, RN
- Jeremiah K O'Shea, M.D.
- Shayla Lanee Oaks, M.A. CFY SLP
- Occumed Inc. (In & Out Express Care)
- Occupational Health Centers of the Southwest P.a. (Concentra Medical Center)
- Tiffany Shanae Odum, OTR/L
- Afia Ofori-Atta
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.