Active NPI
Angela M Brooks, RPH
- Pharmacist
- Rolla, MO
National Provider Identifier
1811271612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2004033687
- Practice address
- 120 S Bishop Ave
Rolla, MO 65401-4215 - Phone
- (573) 426-3338
- Fax
- (573) 426-3168
- NPI assigned
- Sep 28, 2011
- Last updated
- Sep 28, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2004033687 | MO | Primary |
| Pharmacist | 183500000X | 051-293025 | IL |
Addresses
Primary practice location
120 S Bishop Ave
Rolla, MO 65401-4215
Mailing address
120 S Bishop Ave
Rolla, MO 65401-4215
Phone (573) 426-3338
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051-293025 | IL | MD | Pharmacist |
| 2004033687 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Central Missouri Community Health Center | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Four Rivers Community Health Center
- Federally Qualified Health Center (FQHC)
- Rolla, MO
- NPI 1164669172
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317168000000",
"number": "1811271612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 S BISHOP AVE",
"city": "ROLLA",
"state": "MO",
"postal_code": "654014215",
"telephone_number": "573-426-3338",
"fax_number": "573-426-3168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 S BISHOP AVE",
"city": "ROLLA",
"state": "MO",
"postal_code": "654014215",
"telephone_number": "573-426-3338",
"fax_number": "573-426-3168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "ANGELA",
"middle_name": "M",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-28",
"last_updated": "2011-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2004033687",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051-293025",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rolla, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.