Active NPI
Kelley Brook Brockinton, PHARMD
- Critical Care Pharmacist
- Sherwood, AR
National Provider Identifier
1639779291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pharmacist
- License
- PD09208
- Practice address
- 8801 Highway 107
Sherwood, AR 72120-2929 - Phone
- (501) 833-3116
- NPI assigned
- Oct 31, 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 |
|---|---|---|---|---|
| Critical Care Pharmacist | 1835C0205X | PD09208 | AR | Primary |
Addresses
Primary practice location
8801 Highway 107
Sherwood, AR 72120-2929
Mailing address
PO Box 8174
Jacksonville, AR 72078-8174
Phone (501) 650-1343
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 |
|---|---|---|---|
| PD09208 | AR | MD | Critical Care Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Critical Care | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Eastvale, CA
- NPI 1770458945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604102400000",
"number": "1639779291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8174",
"city": "JACKSONVILLE",
"state": "AR",
"postal_code": "720788174",
"telephone_number": "501-650-1343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8801 HIGHWAY 107",
"city": "SHERWOOD",
"state": "AR",
"postal_code": "721202929",
"telephone_number": "501-833-3116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROCKINTON",
"first_name": "KELLEY",
"middle_name": "BROOK",
"name_prefix": "Mrs.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-31",
"last_updated": "2020-10-31",
"certification_date": "2020-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "1835C0205X",
"taxonomy_group": "",
"desc": "Pharmacist, Critical Care",
"state": "AR",
"license": "PD09208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sherwood, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.