Individual provider Active NPI

Brooke Julianna Levister, PHARM. D.

  • Pharmacist
  • Macomb, IL
National Provider Identifier
1740612571
Registry record updated Nov 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051302031 Issued in IL
Practice address
327 E Jackson St
Macomb, IL 61455-2306
Phone
(309) 833-1750
NPI assigned
Aug 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2013028379 MO
Pharmacist 183500000X 051302031 IL Primary

Addresses

Primary practice location

327 E Jackson St
Macomb, IL 61455-2306

Mailing address

327 E Jackson St
Macomb, IL 61455-2306
Phone (309) 833-1750

Other practice location 1

101 E Main St
Willow Springs, MO 65793-1413
Phone (417) 469-3005

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
051302031ILMDPharmacist
2013028379MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Park CVS LLC PastSince Nov 29, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1375488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605916800000",
    "number": "1740612571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 E JACKSON ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552306",
            "telephone_number": "309-833-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 E JACKSON ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552306",
            "telephone_number": "309-833-1750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E Main St",
            "address_purpose": "LOCATION",
            "city": "Willow Springs",
            "state": "MO",
            "postal_code": "657931413",
            "country_code": "US",
            "telephone_number": "417-469-3005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVISTER",
        "first_name": "BROOKE",
        "middle_name": "JULIANNA",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-03",
        "last_updated": "2020-11-21",
        "certification_date": "2020-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2013028379",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051302031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.