Individual provider Active NPI

Brooke King, PHARM D

  • Pharmacist
  • Fairway, KS
National Provider Identifier
1790068997
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2008029238 Issued in MO
Practice address
4330 Shawnee Mission Pkwy
Ste 308
Fairway, KS 66205-2522
Phone
(913) 236-7271
Fax
(913) 236-8929
NPI assigned
Sep 23, 2011
Last updated
Sep 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2008029238 MO Primary
Pharmacist 183500000X 13493 KS

Addresses

Primary practice location

4330 Shawnee Mission Pkwy
Ste 308
Fairway, KS 66205-2522

Mailing address

25575 Metcalf Rd
Louisburg, KS 66053-6319
Phone (913) 575-3095

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
13493KSMDPharmacist
2008029238MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1790068997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25575 METCALF RD",
            "city": "LOUISBURG",
            "state": "KS",
            "postal_code": "660536319",
            "telephone_number": "913-575-3095",
            "fax_number": "913-236-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 SHAWNEE MISSION PKWY",
            "address_2": "STE 308",
            "city": "FAIRWAY",
            "state": "KS",
            "postal_code": "662052522",
            "telephone_number": "913-236-7271",
            "fax_number": "913-236-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "BROOKE",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-23",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2008029238",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "13493",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairway, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.