Active NPI
Carroll Bruister III
- Pharmacist
- Ackerman, MS
National Provider Identifier
1982122289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E6788
- Practice address
- 222 Mabus
Ackerman, MS 39735 - Phone
- (662) 285-6039
- NPI assigned
- Sep 7, 2017
- Last updated
- Sep 7, 2017
- Sex
- Male
- 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 | E6788 | MS | Primary |
Addresses
Primary practice location
222 Mabus
Ackerman, MS 39735
Mailing address
11850 Ms Hwy 15
Ackerman, MS 39735
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 |
|---|---|---|---|
| E6788 | MS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504742400000",
"number": "1982122289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11850 MS HWY 15",
"city": "ACKERMAN",
"state": "MS",
"postal_code": "39735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 MABUS",
"city": "ACKERMAN",
"state": "MS",
"postal_code": "39735",
"telephone_number": "662-285-6039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUISTER",
"first_name": "CARROLL",
"name_prefix": "Dr.",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-07",
"last_updated": "2017-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E6788",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ackerman, MS
- Brandywine Health Services of Mississippi, Inc (Choctaw County Medical Center Rural Health Clinic)
- Brandywine Health Services of Ms Inc (Choctaw County Nursing Center)
- Brandywine Health Services of Ms, Inc. Dba Choctaw Co. EMS (Choctaw County EMS)
- Sarah Breland, DMD
- Heather Brown
- Kellie Rone Cauthen, RN, MSN, NP-C
- Erin Chandler, FNP
- Chandler's RDL LLC (Hometown Urgent Care of Ackerman)
- Choctaw County (Choctaw County Hospital)
- Choctaw County (Choctaw County Nursing Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.