Individual provider Active NPI

Nicholas G Brunelle, PHARM.D., R.PH.

  • Pharmacist
  • Greenville, RI
National Provider Identifier
1689814949
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26383 Issued in MA
Practice address
446 Putnam Pike
Greenville, RI 02828-3054
Phone
(401) 949-1848
Fax
(401) 949-1539
NPI assigned
Feb 26, 2009
Last updated
Dec 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH05206 RI
Pharmacist 183500000X 26383 MA Primary

Addresses

Primary practice location

446 Putnam Pike
Greenville, RI 02828-3054

Mailing address

446 Putnam Pike
Greenville, RI 02828-3054
Phone (401) 949-1848

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, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
26383MAMDPharmacist
RPH05206RIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Stop and Shop Supermarket Co LLC PastSince Dec 13, 2020 Accepting new patients
Stop and Shop Supermarket Co LLC PastSince Dec 13, 2020 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": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1689814949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 PUTNAM PIKE",
            "city": "GREENVILLE",
            "state": "RI",
            "postal_code": "028283054",
            "telephone_number": "401-949-1848",
            "fax_number": "401-949-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 PUTNAM PIKE",
            "city": "GREENVILLE",
            "state": "RI",
            "postal_code": "028283054",
            "telephone_number": "401-949-1848",
            "fax_number": "401-949-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNELLE",
        "first_name": "NICHOLAS",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PHARM.D., R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-26",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "RI",
            "license": "RPH05206",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "26383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, RI

Sources for this page

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