Individual provider Active NPI

Donald Francis Davern, RPH

  • Pharmacist
  • Bloomfield Hills, MI
National Provider Identifier
1053555045
Registry record updated Apr 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6105 Issued in WV
Practice address
35980 Woodward Ave
Suite 325
Bloomfield Hills, MI 48304-0903
Phone
(800) 600-2070
Fax
(248) 647-0011
NPI assigned
Apr 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 6105 WV Primary

Addresses

Primary practice location

35980 Woodward Ave
Suite 325
Bloomfield Hills, MI 48304-0903

Mailing address

4414 Auburn Rd
Huntington, WV 25704-1144
Phone (304) 812-0987

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
6105WVMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1240358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240358400000",
    "number": "1053555045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 AUBURN RD",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257041144",
            "telephone_number": "304-812-0987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35980 WOODWARD AVE",
            "address_2": "SUITE 325",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483040903",
            "telephone_number": "800-600-2070",
            "fax_number": "248-647-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVERN",
        "first_name": "DONALD",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-22",
        "last_updated": "2009-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "6105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; 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.