Individual provider Active NPI

Lee Alan Smith

  • Pharmacist
  • Whitehall, MI
National Provider Identifier
1104185099
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302036587 Issued in MI
Practice address
2755 Holton Whitehall Rd
Whitehall, MI 49461-9516
Phone
(231) 893-5488
NPI assigned
May 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302036587 MI Primary

Addresses

Primary practice location

2755 Holton Whitehall Rd
Whitehall, MI 49461-9516

Mailing address

5404 Sioux Rd
Pentwater, MI 49449-9407

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
5302036587MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores East LP PastSince Aug 18, 2024 Accepting new patients
Rite Aid of Michigan Inc Past Accepting new patients
Rite Aid of Michigan Inc Past Accepting new patients
Wal-Mart Stores East, LP PastSince Aug 18, 2024 Accepting new patients

Organizations & group practices 4

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": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1104185099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5404 SIOUX RD",
            "city": "PENTWATER",
            "state": "MI",
            "postal_code": "494499407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 HOLTON WHITEHALL RD",
            "city": "WHITEHALL",
            "state": "MI",
            "postal_code": "494619516",
            "telephone_number": "231-893-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "LEE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-11",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302036587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitehall, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.