Individual provider Active NPI

Kyle Murray, PHARMD

  • Pharmacist
  • Detroit, MI
National Provider Identifier
1104646397
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302038312 Issued in MI
Practice address
3990 John R St Dept of
Detroit, MI 48201-2059
Phone
(313) 745-8636
Fax
(313) 745-1628
NPI assigned
Oct 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 5302038312 MI
Pharmacist 183500000X 5302038312 MI Primary

Addresses

Primary practice location

3990 John R St Dept of
Detroit, MI 48201-2059

Mailing address

3990 John R St Dept of
Detroit, MI 48201-2059
Phone (313) 745-8636

Other practice location 1

21539 Homer St
Dearborn, MI 48124-2910
Phone (734) 377-6444

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
5302038312MIMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1104646397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST DEPT OF",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012059",
            "telephone_number": "313-745-8636",
            "fax_number": "313-745-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST DEPT OF",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012059",
            "telephone_number": "313-745-8636",
            "fax_number": "313-745-1628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21539 Homer St",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481242910",
            "country_code": "US",
            "telephone_number": "734-377-6444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURRAY",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-14",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MI",
            "license": "5302038312",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302038312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.