Brian Ward Nelson, RPH

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

PS0015183 Issued in FL

Practice address

9350 Dynasty Dr
Target 2369
Fort Myers, FL 33905-5574

Phone

(239) 265-9023

Fax

(239) 265-9033

NPI assigned

Jun 13, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

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.

• North Carolina CVS Pharmacy LLC

  • Pharmacy
  • Winston Salem, NC
  • NPI 1699797258
  NPD (past)

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307923200000",
    "number": "1730474206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9350 DYNASTY DR",
            "address_2": "TARGET 2369",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339055574",
            "telephone_number": "239-265-9023",
            "fax_number": "239-265-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 DYNASTY DR",
            "address_2": "TARGET 2369",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339055574",
            "telephone_number": "239-265-9023",
            "fax_number": "239-265-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BRIAN",
        "middle_name": "WARD",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2011-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "FL",
            "license": "PS0015183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fernando A Neira, DDS
• Nelson L Hadler, LLC
• Nelson L. Hadler, LLC
• Nancy J Nelson-Beliveau, APN
• A Kathleen Nelson, CRNA
• Chad Nelson, P.T.
• Chandra Nelson, RDN
• Ericka Blaufuss Nelson, ARNP
• Forrest Nelson
• Gretchen Nelson, ARNP

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; 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.