Individual provider Active NPI

Brian Michael Knebel, RPH

  • Pharmacist
  • Litchfield, IL
National Provider Identifier
1699374140
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051288337 Issued in IL
Practice address
1205 W Ferdon St
Litchfield, IL 62056-4454
Phone
(217) 324-6197
NPI assigned
Oct 25, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 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 051288337 IL Primary

Addresses

Primary practice location

1205 W Ferdon St
Litchfield, IL 62056-4454

Mailing address

1205 W Ferdon St
Litchfield, IL 62056-4454
Phone (217) 324-6197

Other identifiers 1

IdentifierTypeStateIssuer
1841217114MedicaidIL

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

LicenseStateTypeSpecialty
051288337ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1699374140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 W FERDON ST",
            "city": "LITCHFIELD",
            "state": "IL",
            "postal_code": "620564454",
            "telephone_number": "217-324-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 W FERDON ST",
            "city": "LITCHFIELD",
            "state": "IL",
            "postal_code": "620564454",
            "telephone_number": "217-324-6197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNEBEL",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-25",
        "last_updated": "2020-10-25",
        "certification_date": "2020-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051288337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841217114",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Litchfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.