Active NPI
Debra Brooks
- Pharmacist
- Leesburg, VA
National Provider Identifier
1962782516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202010997
- Practice address
- 424 Sycolin Rd SE
Leesburg, VA 20175-5687 - Phone
- (703) 777-2354
- Fax
- (703) 779-4632
- NPI assigned
- Aug 26, 2011
- Last updated
- Aug 26, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202010997 | VA | Primary |
| Pharmacist | 183500000X | 12290 | MD |
Addresses
Primary practice location
424 Sycolin Rd SE
Leesburg, VA 20175-5687
Mailing address
424 Sycolin Rd SE
Leesburg, VA 20175-5687
Phone (703) 777-2354
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 |
|---|---|---|---|
| 12290 | MD | MD | Clinical Social Worker |
| 0202010997 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314316800000",
"number": "1962782516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 SYCOLIN RD SE",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201755687",
"telephone_number": "703-777-2354",
"fax_number": "703-779-4632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 SYCOLIN RD SE",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201755687",
"telephone_number": "703-777-2354",
"fax_number": "703-779-4632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "DEBRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-08-26",
"last_updated": "2011-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202010997",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "12290",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leesburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.