Individual provider Active NPI

Katie M Fletcher, PHARM.D.

  • Pharmacist
  • Holland, MI
National Provider Identifier
1053999110
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302041993 Issued in MI
Practice address
285 James Street
Holland, MI 49424
Phone
(616) 994-6620
Fax
(616) 399-1967
NPI assigned
Mar 31, 2021
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302041993 MI Primary
Ambulatory Care Pharmacist 1835P2201X 5302041993 MI

Addresses

Primary practice location

285 James Street
Holland, MI 49424

Mailing address

285 James Street
Holland, MI 49424
Phone (616) 994-6620

Other identifiers 1

IdentifierTypeStateIssuer
1457977514MedicaidMI

Other names 1

  • Katie M Fitzpatrick Former name

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
5302041993MIMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1053999110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 JAMES STREET",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49424",
            "telephone_number": "616-994-6620",
            "fax_number": "616-399-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 JAMES STREET",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49424",
            "telephone_number": "616-994-6620",
            "fax_number": "616-399-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "KATIE",
        "middle_name": "M",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302041993",
            "primary": true
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "MI",
            "license": "5302041993",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457977514",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "FITZPATRICK",
            "middle_name": "M",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.