Active NPI
Corey Bentley Brown, PHARMD, RPH
- Pharmacist
- Louisville, KY
National Provider Identifier
1700284205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 017204
- Practice address
- 1101 E Washington St Ste a
Louisville, KY 40206-1822 - Phone
- (502) 861-5210
- NPI assigned
- Dec 15, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 017204 | KY | Primary |
Addresses
Primary practice location
1101 E Washington St Ste a
Louisville, KY 40206-1822
Mailing address
2616 Titleist Rd
Louisville, KY 40242-6900
Phone (502) 265-8904
Other practice location 1
2616 Titleist Rd
Louisville, KY 40242-6900
Phone (502) 265-8904
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 017204 | Other | KY | BOARD OF PHARMACY |
| 26025895A | Other | IN | BOARD OF PHARMACY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 017204 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avita Drugs Kentucky, LLC | Current | Accepting new patients | |
| Pennyrile Precision RX Consulting, PLLC | Pharmacist | Current | Accepting new patients |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1101 E Washington St
Ste A
Louisville, KY 40206
Phone (469) 592-2011
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Avita Pharmacy 1081
- Community/Retail Pharmacy
- Louisville, KY
- NPI 1528841236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744243200000",
"number": "1700284205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2616 TITLEIST RD",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402426900",
"telephone_number": "502-265-8904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 E WASHINGTON ST STE A",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402061822",
"telephone_number": "502-861-5210"
}
],
"practiceLocations": [
{
"address_1": "2616 Titleist Rd",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402426900",
"country_code": "US",
"telephone_number": "502-265-8904",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROWN",
"first_name": "COREY",
"middle_name": "BENTLEY",
"name_prefix": "Dr.",
"credential": "PHARMD, RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-15",
"last_updated": "2025-04-10",
"certification_date": "2025-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "017204",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY",
"identifier": "017204",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY",
"identifier": "26025895A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.