Active NPI
Ayesha Brown, RPH
- Pharmacist
- Galesburg, IL
National Provider Identifier
1669070157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051294188
- Practice address
- 2030 E Main St
Galesburg, IL 61401-5460 - Phone
- (309) 342-1619
- Fax
- (309) 342-2993
- NPI assigned
- Oct 15, 2020
- Last updated
- Oct 15, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051294188 | IL | Primary |
Addresses
Primary practice location
2030 E Main St
Galesburg, IL 61401-5460
Mailing address
1706 Baird Ave
Galesburg, IL 61401-6306
Phone (786) 325-1242
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051294188 | IL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hy-Vee Inc | Past | Accepting new patients | |
| Hy-Vee Inc | 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, 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": "1602720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602720000000",
"number": "1669070157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1706 BAIRD AVE",
"city": "GALESBURG",
"state": "IL",
"postal_code": "614016306",
"telephone_number": "786-325-1242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2030 E MAIN ST",
"city": "GALESBURG",
"state": "IL",
"postal_code": "614015460",
"telephone_number": "309-342-1619",
"fax_number": "309-342-2993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "AYESHA",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-15",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051294188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Galesburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.