Individual provider Active NPI

Michelle Grey

  • Pharmacist
  • Groton, CT
National Provider Identifier
1033628250
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0014109 Issued in CT
Practice address
915 Poquonnock Rd
Groton, CT 06340-4257
Phone
(860) 446-0144
NPI assigned
Sep 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X PCT.0014109 CT Primary

Addresses

Primary practice location

915 Poquonnock Rd
Groton, CT 06340-4257

Mailing address

915 Poquonnock Rd
Groton, CT 06340-4257

Other practice location 1

25 Broadway Ave
Mystic, CT 06355-2834
Phone (860) 536-5635

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
PCT.0014109CTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1033628250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 POQUONNOCK RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 POQUONNOCK RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404257",
            "telephone_number": "860-446-0144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Mystic",
            "state": "CT",
            "postal_code": "063552834",
            "country_code": "US",
            "telephone_number": "860-536-5635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREY",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0014109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.