Individual provider Active NPI

Jeffrey Alan Dennis, RPH

  • Pharmacist
  • McBain, MI
National Provider Identifier
1235762907
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302028882 Issued in MI
Practice address
119 N Roland St
MC Bain, MI 49657-9683
Phone
(231) 825-8175
Fax
(231) 825-8130
NPI assigned
Feb 20, 2020
Last updated
Feb 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302028882 MI Primary

Addresses

Primary practice location

119 N Roland St
MC Bain, MI 49657-9683

Mailing address

119 N Roland St
MC Bain, MI 49657-9683
Phone (231) 825-8175

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
5302028882MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1235762907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 N ROLAND ST",
            "city": "MC BAIN",
            "state": "MI",
            "postal_code": "496579683",
            "telephone_number": "231-825-8175",
            "fax_number": "231-825-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 N ROLAND ST",
            "city": "MC BAIN",
            "state": "MI",
            "postal_code": "496579683",
            "telephone_number": "231-825-8175",
            "fax_number": "231-825-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302028882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McBain, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.