Active NPI
Brenae Wilson, PHARMD
- Ambulatory Care Pharmacist
- Columbia, SC
National Provider Identifier
1750019121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 43401
- Practice address
- 5 Richland Medical Park Dr
Columbia, SC 29203-6863 - Phone
- (803) 434-6482
- NPI assigned
- Aug 12, 2022
- Last updated
- Aug 12, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 43401 | SC | Primary |
Addresses
Primary practice location
5 Richland Medical Park Dr
Columbia, SC 29203-6863
Mailing address
144 Timbergate Rd
Lexington, SC 29073-8833
Phone (803) 404-9064
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 |
|---|---|---|---|
| 43401 | SC | MD | Ambulatory Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660262400000",
"number": "1750019121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 TIMBERGATE RD",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290738833",
"telephone_number": "803-404-9064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 RICHLAND MEDICAL PARK DR",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292036863",
"telephone_number": "803-434-6482"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "BRENAE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-12",
"last_updated": "2022-08-12",
"certification_date": "2022-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "SC",
"license": "43401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.