Individual provider Active NPI

Michael Lynn Morton, R.PH.

  • Pharmacist
  • Salem, IL
National Provider Identifier
1245509603
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051030822 Issued in IL
Practice address
215 N Broadway Ave
Salem, IL 62881-1511
Phone
(618) 548-0070
Fax
(618) 548-9846
NPI assigned
Dec 14, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051030822 IL Primary

Addresses

Primary practice location

215 N Broadway Ave
Salem, IL 62881-1511

Mailing address

215 N Broadway Ave
Salem, IL 62881-1511
Phone (618) 548-0070

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
051030822ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
MLM Pharmacy, Inc. Current Accepting new patients

Locations

215 N Broadway Ave
Salem, IL 62881
Phone (618) 548-0070

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1245509603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N BROADWAY AVE",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628811511",
            "telephone_number": "618-548-0070",
            "fax_number": "618-548-9846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N BROADWAY AVE",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628811511",
            "telephone_number": "618-548-0070",
            "fax_number": "618-548-9846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTON",
        "first_name": "MICHAEL",
        "middle_name": "LYNN",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-14",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051030822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.