Individual provider Active NPI

Michael R Robertson, R.PH.

  • Pharmacist
  • Irmo, SC
National Provider Identifier
1154528701
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
4979 Issued in SC
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.

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

LicenseStateTypeSpecialty
4979SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Kroger Co Past Accepting new patients
Kroger Co Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 4979 SC Primary

Addresses

NPPES NPI Registry

Primary 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.

Verify at the official NPI Registry.