Individual provider Active NPI

Crystal Ann Osunde, PHARMD

  • Pharmacist
  • West Bloomfield, MI
National Provider Identifier
1215107677
Registry record updated Mar 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302038034 Issued in MI
Practice address
6620 Crescent GRN
West Bloomfield, MI 48322-1325
Phone
(814) 880-5505
NPI assigned
Mar 1, 2008
Last updated
Mar 1, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302038034 MI Primary
Pharmacist 183500000X RP440318 PA

Addresses

Primary practice location

6620 Crescent GRN
West Bloomfield, MI 48322-1325

Mailing address

6620 Crescent GRN
West Bloomfield, MI 48322-1325
Phone (814) 880-5505

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
5302038034MIMDPharmacist
RP440318PAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1204329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204329600000",
    "number": "1215107677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 CRESCENT GRN",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483221325",
            "telephone_number": "814-880-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 CRESCENT GRN",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483221325",
            "telephone_number": "814-880-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSUNDE",
        "first_name": "CRYSTAL",
        "middle_name": "ANN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-01",
        "last_updated": "2008-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302038034",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP440318",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2008; 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.