Active NPI
Sydney Brodeur, PHARMD
- Pharmacist
- Burlington, NC
National Provider Identifier
1912554411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28889
- Practice address
- 1149 University Dr
Burlington, NC 27215-8798 - Phone
- (336) 584-6041
- NPI assigned
- Aug 20, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 28889 | NC | Primary |
Addresses
Primary practice location
1149 University Dr
Burlington, NC 27215-8798
Mailing address
622 Waterstone Park Cir
Hillsborough, NC 27278-9884
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28889 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients | |
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients |
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": "1566259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566259200000",
"number": "1912554411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "622 WATERSTONE PARK CIR",
"city": "HILLSBOROUGH",
"state": "NC",
"postal_code": "272789884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1149 UNIVERSITY DR",
"city": "BURLINGTON",
"state": "NC",
"postal_code": "272158798",
"telephone_number": "336-584-6041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODEUR",
"first_name": "SYDNEY",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-20",
"last_updated": "2019-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "28889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.