Individual provider Active NPI

Brian Egerbrecht

  • Pharmacist
  • Kiel, WI
National Provider Identifier
1922437722
Registry record updated Nov 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13406-040 Issued in WI
Practice address
1120 State Road 67
Kiel, WI 53042-1630
Phone
(920) 894-3604
Fax
(920) 894-7644
NPI assigned
Nov 2, 2013
Last updated
Nov 2, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13406-040 WI Primary

Addresses

Primary practice location

1120 State Road 67
Kiel, WI 53042-1630

Mailing address

1120 State Road 67
Kiel, WI 53042-1630
Phone (920) 894-3604

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

LicenseStateTypeSpecialty
13406-040WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383350400000",
    "number": "1922437722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 STATE ROAD 67",
            "city": "KIEL",
            "state": "WI",
            "postal_code": "530421630",
            "telephone_number": "920-894-3604",
            "fax_number": "920-894-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 STATE ROAD 67",
            "city": "KIEL",
            "state": "WI",
            "postal_code": "530421630",
            "telephone_number": "920-894-3604",
            "fax_number": "920-894-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGERBRECHT",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "13406-040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kiel, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; 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.