Individual provider Active NPI

Patricia L Forrester, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Fenton, MI
National Provider Identifier
1033473400
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
5302028896 Issued in MI
Practice address
2521 N Long Lake Rd
Fenton, MI 48430-8840
Phone
(810) 750-0842
NPI assigned
Jun 29, 2012
Last updated
Jun 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 5302028896 MI Primary

Addresses

Primary practice location

2521 N Long Lake Rd
Fenton, MI 48430-8840

Mailing address

2521 N Long Lake Rd
Fenton, MI 48430-8840
Phone (810) 750-0842

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
5302028896MIMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1033473400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 N LONG LAKE RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484308840",
            "telephone_number": "810-750-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 N LONG LAKE RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484308840",
            "telephone_number": "810-750-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORRESTER",
        "first_name": "PATRICIA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2012-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MI",
            "license": "5302028896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.