Active NPI
Michael Damon Brown, P.D.
- Pharmacist
- Bentonville, AR
National Provider Identifier
1801808191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD07422
- Practice address
- 204 Linebarger LN
Bentonville, AR 72712-3910 - Phone
- (479) 451-1112
- Fax
- (479) 451-8634
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD07422 | AR | Primary |
Addresses
Primary practice location
204 Linebarger LN
Bentonville, AR 72712-3910
Mailing address
204 Linebarger LN
Bentonville, AR 72712-3910
Phone (479) 451-1112
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD07422 | AR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801808191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 LINEBARGER LN",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727123910",
"telephone_number": "479-451-1112",
"fax_number": "479-451-8634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 LINEBARGER LN",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727123910",
"telephone_number": "479-451-1112",
"fax_number": "479-451-8634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "MICHAEL",
"middle_name": "DAMON",
"name_prefix": "Mr.",
"credential": "P.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD07422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bentonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.