Active NPI
Michael R Robertson, R.PH.
- Pharmacist
- Irmo, SC
National Provider Identifier
1154528701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4979
- Practice address
- 7467 Saint Andrews Rd Ste 6
Irmo, SC 29063-2876 - Phone
- (803) 732-0426
- NPI assigned
- Jun 28, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Irmo, SC
- NPI 1447284161
-
- Community/Retail Pharmacy
- Bethlehem, GA
- NPI 1154294205
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 |
|---|---|---|---|
| 4979 | SC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Kroger Co | Past | Accepting new patients | |
| Kroger Co | Past | Accepting new patients |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4979 | SC | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
7467 Saint Andrews Rd Ste 6
Irmo, SC 29063-2876
Mailing address
509 Winding Way
Columbia, SC 29212-1354
Phone (803) 781-5296
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.
{
"created_epoch": "1182988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154528701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 WINDING WAY",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292121354",
"telephone_number": "803-781-5296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7467 SAINT ANDREWS RD STE 6",
"city": "IRMO",
"state": "SC",
"postal_code": "290632876",
"telephone_number": "803-732-0426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "MICHAEL",
"middle_name": "R",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "4979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Irmo, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.