Individual provider Active NPI

Marsha Dodge

  • Pharmacist
  • Kokomo, IN
National Provider Identifier
1023405248
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S016988 Issued in AZ
Practice address
3010 Lamplighter LN
Kokomo, IN 46902-8124
Phone
(765) 437-7014
NPI assigned
Apr 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S016988 AZ Primary
Pharmacist 183500000X 26015488A IN
Pharmacist 183500000X PH-2899 HI

Addresses

Primary practice location

3010 Lamplighter LN
Kokomo, IN 46902-8124

Mailing address

3010 Lamplighter LN
Kokomo, IN 46902-8124
Phone (765) 437-7014

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
S016988AZMDPharmacist
PH-2899HIMDPharmacist
26015488AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1430006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1023405248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 LAMPLIGHTER LN",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469028124",
            "telephone_number": "765-437-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 LAMPLIGHTER LN",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469028124",
            "telephone_number": "765-437-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODGE",
        "first_name": "MARSHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-26",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S016988",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26015488A",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "HI",
            "license": "PH-2899",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.