Individual provider Active NPI

Mara Street

  • Pharmacist
  • Great Falls, MT
National Provider Identifier
1164851978
Registry record updated Nov 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
3560 Issued in MT
Practice address
1601 Market Place Dr
Great Falls, MT 59404-3481
Phone
(406) 771-0475
Fax
(406) 771-1425
NPI assigned
Nov 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 3560 MT Primary

Addresses

Primary practice location

1601 Market Place Dr
Great Falls, MT 59404-3481

Mailing address

1601 Market Place Dr
Great Falls, MT 59404-3481
Phone (406) 771-0475

Other names 1

  • Mara Williams Former name

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

State licenses

LicenseStateTypeSpecialty
3560MTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Smiths Food & Drug Centers Inc Past Accepting new patients
Smith'S Food & Drug Centers Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383350400000",
    "number": "1164851978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 MARKET PLACE DR",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594043481",
            "telephone_number": "406-771-0475",
            "fax_number": "406-771-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 MARKET PLACE DR",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594043481",
            "telephone_number": "406-771-0475",
            "fax_number": "406-771-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREET",
        "first_name": "MARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "3560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARA",
            "last_name": "WILLIAMS",
            "credential": "RPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; 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.