Individual provider Active NPI

Carl Ndangoh, PHARM D

  • Pharmacist
  • Southfield, MI
National Provider Identifier
1023631660
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302039573 Issued in MI
Practice address
2 Towne SQ
Southfield, MI 48076-3769
Phone
(313) 208-7376
NPI assigned
May 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302039573 MI Primary

Addresses

Primary practice location

2 Towne SQ
Southfield, MI 48076-3769

Mailing address

6413 Belhaven Dr
Fort Worth, TX 76123-2097
Phone (817) 791-8145

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302039573MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1023631660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6413 BELHAVEN DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761232097",
            "telephone_number": "817-791-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TOWNE SQ",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763769",
            "telephone_number": "313-208-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDANGOH",
        "first_name": "CARL",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302039573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; 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.