Individual provider Active NPI

Michael Andraws

  • Pharmacist
  • Paducah, KY
National Provider Identifier
1053945956
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
41949 Issued in SC
Practice address
538 Lone Oak Rd
Paducah, KY 42003-4538
Phone
(270) 443-8855
NPI assigned
Feb 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 41949 SC Primary

Addresses

Primary practice location

538 Lone Oak Rd
Paducah, KY 42003-4538

Mailing address

1 The Pkwy
Greenville, SC 29615-5026

Other practice location 1

1 The Pkwy
Greenville, SC 29615-5026
Phone (864) 288-9334

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
41949SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Feb 27, 2022 Accepting new patients
Kentucky CVS Pharmacy, L.L.C. PastSince Oct 23, 2022 Accepting new patients
Walgreen Co PastSince Mar 1, 2020 Accepting new patients

Locations

1 The Pkwy
Greenville, SC 29615
Phone (864) 288-9334

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1053945956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 THE PKWY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296155026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 LONE OAK RD",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420034538",
            "telephone_number": "270-443-8855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 The Pkwy",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296155026",
            "country_code": "US",
            "telephone_number": "864-288-9334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDRAWS",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-28",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "41949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.