Active NPI
Brett Gillis
- Pharmacist
- Yreka, CA
National Provider Identifier
1649028309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 63548
- Practice address
- 1906 Fort Jones Rd
Yreka, CA 96097-9530 - Phone
- (530) 842-9060
- NPI assigned
- May 8, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 63548 | CA | Primary |
Addresses
Primary practice location
1906 Fort Jones Rd
Yreka, CA 96097-9530
Mailing address
1906 Fort Jones Rd
Yreka, CA 96097-9530
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 63548 | Other | CA | BOARD OF PHARMACY LICENSE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715126400000",
"number": "1649028309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1906 FORT JONES RD",
"city": "YREKA",
"state": "CA",
"postal_code": "960979530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1906 FORT JONES RD",
"city": "YREKA",
"state": "CA",
"postal_code": "960979530",
"telephone_number": "530-842-9060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLIS",
"first_name": "BRETT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-08",
"last_updated": "2024-05-08",
"certification_date": "2024-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "63548",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY LICENSE",
"identifier": "63548",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yreka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.