Individual provider Active NPI

Brook Medley, PHARMD

  • Pharmacist
  • Hawkinsville, GA
National Provider Identifier
1851980106
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH020865 Issued in GA
Practice address
342 Industrial Blvd
Hawkinsville, GA 31036-2103
Phone
(478) 867-3645
NPI assigned
Jan 12, 2021
Last updated
Jan 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Pharmacist 1835G0303X IND-922627 GA
Pharmacist 183500000X RPH020865 GA Primary

Addresses

Primary practice location

342 Industrial Blvd
Hawkinsville, GA 31036-2103

Mailing address

342 Industrial Blvd
Hawkinsville, GA 31036-2103
Phone (478) 867-3645

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
RPH020865GAMDPharmacist
IND-922627GAMDGeriatric Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Ancillary Services, Inc. PastSince Jan 17, 2021 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1851980106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 INDUSTRIAL BLVD",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310362103",
            "telephone_number": "478-867-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 INDUSTRIAL BLVD",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310362103",
            "telephone_number": "478-867-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLEY",
        "first_name": "BROOK",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "GA",
            "license": "IND-922627",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH020865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.