NPIMap

Individual provider Active NPI

Timothy Donald Brown, PHARMD

  • Pharmacist
  • Wendell, ID
National Provider Identifier
1710323712
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P5751 Issued in ID
Practice address
280 S Idaho St
Wendell, ID 83355-5200
Phone
(208) 536-5761
Fax
(208) 536-5852
NPI assigned
May 16, 2013
Last updated
May 16, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P5751 ID Primary
Nuclear Pharmacist 1835N0905X P5751 ID

Addresses

Primary practice location

280 S Idaho St
Wendell, ID 83355-5200

Mailing address

PO Box 487
Wendell, ID 83355-0487
Phone (208) 536-5761

Other identifiers 1

IdentifierTypeStateIssuer
P5751OtherIDSTATE LICENSE NUMBER

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
P5751IDMDNuclear Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1710323712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 487",
            "city": "WENDELL",
            "state": "ID",
            "postal_code": "833550487",
            "telephone_number": "208-536-5761",
            "fax_number": "208-536-5852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 S IDAHO ST",
            "city": "WENDELL",
            "state": "ID",
            "postal_code": "833555200",
            "telephone_number": "208-536-5761",
            "fax_number": "208-536-5852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TIMOTHY",
        "middle_name": "DONALD",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-16",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P5751",
            "primary": true
        },
        {
            "code": "1835N0905X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nuclear",
            "state": "ID",
            "license": "P5751",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "P5751",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wendell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.