Individual provider Active NPI

Robert Walter Fillmore, RPH

  • Pharmacist
  • Saginaw, MI
National Provider Identifier
1215269477
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302020444 Issued in MI
Practice address
5135 Gratiot Rd
Saginaw, MI 48638-6032
Phone
(989) 797-0990
Fax
(989) 793-9896
NPI assigned
Feb 12, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302020444 MI Primary

Addresses

Primary practice location

5135 Gratiot Rd
Saginaw, MI 48638-6032

Mailing address

5135 Gratiot Rd
Saginaw, MI 48638-6032
Phone (989) 797-0990

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
5302020444MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1215269477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5135 GRATIOT RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486386032",
            "telephone_number": "989-797-0990",
            "fax_number": "989-793-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5135 GRATIOT RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486386032",
            "telephone_number": "989-797-0990",
            "fax_number": "989-793-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLMORE",
        "first_name": "ROBERT",
        "middle_name": "WALTER",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-12",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302020444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; 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.