Individual provider Active NPI

Brandon Jabero, PHARMD

  • Pharmacist
  • Canton, MI
National Provider Identifier
1669938619
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302042264 Issued in MI
Practice address
41460 Haggerty Cir S
Canton, MI 48188-2227
Phone
(888) 282-5166
NPI assigned
Feb 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302042264 MI Primary

Addresses

Primary practice location

41460 Haggerty Cir S
Canton, MI 48188-2227

Mailing address

2434 Trevor Dr
Commerce Township, MI 48390-2773
Phone (248) 730-0788

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

LicenseStateTypeSpecialty
5302042264MIMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1669938619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2434 TREVOR DR",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483902773",
            "telephone_number": "248-730-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41460 HAGGERTY CIR S",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882227",
            "telephone_number": "888-282-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABERO",
        "first_name": "BRANDON",
        "name_prefix": "Mr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-14",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302042264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.