Individual provider Active NPI

Brittany Nicole Dillard

  • Ambulatory Care Pharmacist
  • Kentwood, MI
National Provider Identifier
1992295190
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
5302042557 Issued in MI
Practice address
4600 Breton Rd SE Ste 102
Kentwood, MI 49508-5220
Phone
(616) 391-9705
NPI assigned
May 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care PharmacistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1835P2201X 5302042557 MI Primary

Addresses

Primary practice location

4600 Breton Rd SE Ste 102
Kentwood, MI 49508-5220

Mailing address

665 Seward Ave NW Ste 320
Grand Rapids, MI 49504-5190
Phone (616) 267-7029

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
5302042557MIMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1992295190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 SEWARD AVE NW STE 320",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045190",
            "telephone_number": "616-267-7029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 BRETON RD SE STE 102",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085220",
            "telephone_number": "616-391-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLARD",
        "first_name": "BRITTANY",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "MI",
            "license": "5302042557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; 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.