Individual provider Active NPI

Brian Keith Tatro, R.PH.

  • Pharmacist
  • Decatur, IL
National Provider Identifier
1871139030
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051-037717 Issued in IL
Practice address
3070 N Water St
Decatur, IL 62526-1991
Phone
(217) 877-1327
Fax
(309) 877-1328
NPI assigned
Nov 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051-037717 IL Primary

Addresses

Primary practice location

3070 N Water St
Decatur, IL 62526-1991

Mailing address

3070 N Water St
Decatur, IL 62526-1991
Phone (217) 877-1327

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

LicenseStateTypeSpecialty
051-037717ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I CurrentSince Apr 27, 2025 Accepting new patients
Kroger Limited Partnership I PastSince Nov 24, 2019 Accepting new patients

Locations

3070 N Water St
Decatur, IL 62526
Phone (217) 877-1327

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1871139030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3070 N WATER ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625261991",
            "telephone_number": "217-877-1327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3070 N WATER ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625261991",
            "telephone_number": "217-877-1327",
            "fax_number": "309-877-1328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATRO",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-22",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051-037717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; 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.