Active NPI
Brady M Smith, PHARMD
- Pharmacist
- Springfield, MO
National Provider Identifier
1699449322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2022026006
- Practice address
- 2650 W Kearney St
Springfield, MO 65803-2037 - Phone
- (417) 865-1547
- NPI assigned
- Aug 5, 2021
- Last updated
- Jul 7, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 2018039951 | MO | |
| Pharmacist | 183500000X | 2022026006 | MO | Primary |
Addresses
Primary practice location
2650 W Kearney St
Springfield, MO 65803-2037
Mailing address
2749 N Washington Ave
Springfield, MO 65803-3562
Phone (417) 825-5510
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2022026006 | MO | MD | Pharmacist |
| 2018039951 | MO | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Food Merchants LLC | Current | Accepting new patients | |
| Food Merchants LLC | Past | Accepting new patients |
Locations
2650 W Kearney St
Springfield, MO 65803
Phone (417) 865-1547
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": "1628121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657152000000",
"number": "1699449322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2749 N WASHINGTON AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658033562",
"telephone_number": "417-825-5510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 W KEARNEY ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658032037",
"telephone_number": "417-865-1547"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "BRADY",
"middle_name": "M",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-05",
"last_updated": "2022-07-07",
"certification_date": "2022-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MO",
"license": "2018039951",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2022026006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.