Individual provider Active NPI

Michael Herman, PHARMD

  • Pharmacist
  • Lacey, WA
National Provider Identifier
1114320835
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60482964 Issued in WA
Practice address
1138 Golf Club Rd SE
Apt 102
Lacey, WA 98503-2393
Phone
(619) 922-0033
NPI assigned
Oct 8, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60482964 WA Primary

Addresses

Primary practice location

1138 Golf Club Rd SE
Apt 102
Lacey, WA 98503-2393

Mailing address

1138 Golf Club Rd SE
Apt 102
Lacey, WA 98503-2393
Phone (619) 922-0033

Other identifiers 1

IdentifierTypeStateIssuer
PH60482964OtherWAPHARMACY LICENSE

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
PH60482964WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1114320835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 GOLF CLUB RD SE",
            "address_2": "APT 102",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985032393",
            "telephone_number": "619-922-0033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 GOLF CLUB RD SE",
            "address_2": "APT 102",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985032393",
            "telephone_number": "619-922-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMAN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-08",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60482964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "PH60482964",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; 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.