Active NPI
Lily A Cicci
- Pharmacist
- Midland, MI
National Provider Identifier
1245513159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302038113
- Practice address
- 1615 N. Saginaw Rd
Midland, MI 48640 - Phone
- (989) 832-2491
- Fax
- (989) 832-2671
- NPI assigned
- Sep 27, 2011
- Last updated
- Sep 27, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 5302038113 | MI | Primary |
Addresses
Primary practice location
1615 N. Saginaw Rd
Midland, MI 48640
Mailing address
1615 N. Saginaw Rd
Midland, MI 48640
Phone (989) 832-2491
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992710297 | Medicaid | MI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302038113 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317081600000",
"number": "1245513159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1615 N. SAGINAW RD",
"city": "MIDLAND",
"state": "MI",
"postal_code": "48640",
"telephone_number": "989-832-2491",
"fax_number": "989-832-2671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 N. SAGINAW RD",
"city": "MIDLAND",
"state": "MI",
"postal_code": "48640",
"telephone_number": "989-832-2491",
"fax_number": "989-832-2671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CICCI",
"first_name": "LILY",
"middle_name": "A",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-27",
"last_updated": "2011-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302038113",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1992710297",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.