Individual provider Active NPI

Mackenzie Brown Monroe, PHARMD

  • Pharmacist
  • Waterloo, IA
National Provider Identifier
1689018996
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21756 Issued in IA
Practice address
1825 Logan Ave
Waterloo, IA 50703-1916
Phone
(319) 235-3941
NPI assigned
Apr 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21756 IA Primary

Addresses

Primary practice location

1825 Logan Ave
Waterloo, IA 50703-1916

Mailing address

1111 6TH Avenue
Des Moines, IA 50314
Phone (515) 247-3280

Other practice location 1

1111 6th Ave
Des Moines, IA 50314-2613
Phone (515) 247-3280

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
21756IAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1689018996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 6TH AVENUE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "50314",
            "telephone_number": "515-247-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 LOGAN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031916",
            "telephone_number": "319-235-3941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503142613",
            "country_code": "US",
            "telephone_number": "515-247-3280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONROE",
        "first_name": "MACKENZIE",
        "middle_name": "BROWN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-18",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "21756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.

Verify at the official NPI Registry.