Individual provider Active NPI

Beth Anne Gielecki, RPH

  • Pharmacist
  • Saint Clair Shores, MI
National Provider Identifier
1225456049
Registry record updated Mar 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302032138 Issued in MI
Practice address
22906 Lake Blvd
Saint Clair Shores, MI 48082-2727
Phone
(586) 668-1959
Fax
(586) 298-6284
NPI assigned
Mar 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302032138 MI Primary

Addresses

Primary practice location

22906 Lake Blvd
Saint Clair Shores, MI 48082-2727

Mailing address

22906 Lake Blvd
Saint Clair Shores, MI 48082-2727
Phone (586) 668-1959

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
5302032138MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396051200000",
    "number": "1225456049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22906 LAKE BLVD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480822727",
            "telephone_number": "586-668-1959",
            "fax_number": "586-298-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22906 LAKE BLVD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480822727",
            "telephone_number": "586-668-1959",
            "fax_number": "586-298-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIELECKI",
        "first_name": "BETH",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-29",
        "last_updated": "2014-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302032138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2014; 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.