Active NPI
Stephan J Wilcox, R.PH.
- Pharmacist
- Dimondale, MI
National Provider Identifier
1083600464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302411063
- Practice address
- 140 East Rd
Dimondale, MI 48821-8705 - Phone
- (517) 646-9274
- Fax
- (517) 646-9278
- NPI assigned
- Sep 21, 2005
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302411063 | MI | Primary |
Addresses
Primary practice location
140 East Rd
Dimondale, MI 48821-8705
Mailing address
140 East Rd
Dimondale, MI 48821-8705
Phone (517) 646-9274
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302411063 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wilcox Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1083600464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 EAST RD",
"city": "DIMONDALE",
"state": "MI",
"postal_code": "488218705",
"telephone_number": "517-646-9274",
"fax_number": "517-646-9278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 EAST RD",
"city": "DIMONDALE",
"state": "MI",
"postal_code": "488218705",
"telephone_number": "517-646-9274",
"fax_number": "517-646-9278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOX",
"first_name": "STEPHAN",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-21",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302411063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dimondale, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.