Active NPI
Barbara Marie Mattzela, RPH.
- Pharmacist
- Muskegon, MI
National Provider Identifier
1225350622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302029400
- Practice address
- 1501 E Apple Ave Ste C
Muskegon, MI 49442-3762 - Phone
- (231) 773-9188
- Fax
- (231) 773-1451
- NPI assigned
- Feb 25, 2010
- Last updated
- Feb 25, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302029400 | MI | Primary |
Addresses
Primary practice location
1501 E Apple Ave Ste C
Muskegon, MI 49442-3762
Mailing address
3080 Dalson Rd
Twin Lake, MI 49457-9208
Phone (231) 773-9188
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 |
|---|---|---|---|
| 5302029400 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267056000000",
"number": "1225350622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3080 DALSON RD",
"city": "TWIN LAKE",
"state": "MI",
"postal_code": "494579208",
"telephone_number": "231-773-9188",
"fax_number": "231-773-1451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 E APPLE AVE STE C",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494423762",
"telephone_number": "231-773-9188",
"fax_number": "231-773-1451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTZELA",
"first_name": "BARBARA",
"middle_name": "MARIE",
"credential": "RPH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-25",
"last_updated": "2010-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302029400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.