Active NPI
Kellen Michael Brush
- Pharmacist
- Menomonee Falls, WI
National Provider Identifier
1871288092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21506
- Practice address
- N83W15701 Appleton Ave
Menomonee Falls, WI 53051-3042 - Phone
- (262) 251-3890
- NPI assigned
- Apr 5, 2023
- Sex
- Male
- Sole proprietor
- No
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 | 21506 | WI | Primary |
Addresses
Primary practice location
N83W15701 Appleton Ave
Menomonee Falls, WI 53051-3042
Mailing address
1246 N Cass St
Milwaukee, WI 53202-2706
Phone (414) 303-0413
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 |
|---|---|---|---|
| 21506 | WI | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680652800000",
"number": "1871288092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1246 N CASS ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532022706",
"telephone_number": "414-303-0413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N83W15701 APPLETON AVE",
"city": "MENOMONEE FALLS",
"state": "WI",
"postal_code": "530513042",
"telephone_number": "262-251-3890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUSH",
"first_name": "KELLEN",
"middle_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-05",
"last_updated": "2023-04-05",
"certification_date": "2023-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "21506",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menomonee Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.