Individual provider Active NPI

Michelle Rae McKay, PHARMD, RPH

  • Pharmacist
  • Fargo, ND
National Provider Identifier
1154096717
Registry record updated Aug 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH5466 Issued in ND
Practice address
1100 19TH Ave N # 168
Fargo, ND 58102-5906
Phone
(701) 238-6794
NPI assigned
Aug 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH121212 MN
Pharmacist 183500000X 6126 SD
Pharmacist 183500000X RPH5466 ND Primary

Addresses

Primary practice location

1100 19TH Ave N # 168
Fargo, ND 58102-5906

Mailing address

1100 19TH Ave N # 168
Fargo, ND 58102-5906
Phone (701) 238-6794

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, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH121212MNMDPharmacist
RPH5466NDMDPharmacist
6126SDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1628899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628899200000",
    "number": "1154096717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 19TH AVE N # 168",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581025906",
            "telephone_number": "701-238-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 19TH AVE N # 168",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581025906",
            "telephone_number": "701-238-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKAY",
        "first_name": "MICHELLE",
        "middle_name": "RAE",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-14",
        "last_updated": "2021-08-14",
        "certification_date": "2021-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "RPH121212",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SD",
            "license": "6126",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "RPH5466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

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