NPIMap

Organization Active NPI

Ultrasource, Inc.

  • Pharmacist
  • Wichita, KS
National Provider Identifier
1861479586
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10876 Issued in KS
Legal business name
ULTRASOURCE, INC.
Practice address
2331 N Brandon Cir
Wichita, KS 67226-4511
Phone
(316) 630-8170
Fax
(316) 630-8170
NPI assigned
Dec 22, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Jeanine Ann Brizendine, R.PH.NPI 1225372089
Title
President
Phone
(316) 630-8170

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10876 KS Primary

Addresses

Primary practice location

2331 N Brandon Cir
Wichita, KS 67226-4511

Mailing address

2331 N Brandon Cir
Wichita, KS 67226-4511
Phone (316) 630-8170

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861479586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 N BRANDON CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672264511",
            "telephone_number": "316-630-8170",
            "fax_number": "316-630-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 N BRANDON CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672264511",
            "telephone_number": "316-630-8170",
            "fax_number": "316-630-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTRASOURCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRIZENDINE",
        "authorized_official_first_name": "JEANINE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "316-630-8170",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "10876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.