Active NPI
David Joseph Miller, RPH, PHD
- Pharmacist
- Grand Rapids, MI
National Provider Identifier
1245712116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302027363
- Practice address
- 4021 Cascade Rd SE
Suite 50
Grand Rapids, MI 49546 - Phone
- (616) 974-9792
- Fax
- (616) 464-3469
- NPI assigned
- Sep 6, 2018
- Sex
- Male
- 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 | 5302027363 | MI | Primary |
Addresses
Primary practice location
4021 Cascade Rd SE
Suite 50
Grand Rapids, MI 49546
Mailing address
Keystone Pharmacy
4021 Cascade Rd SE Suite 50
Grand Rapids, MI 49546
Phone (616) 974-9792
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
- Doctor of Philosophy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302027363 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Keystone Pharmacy, Inc. | Current | Accepting new patients | |
| Keystone Pharmacy Inc | Current | Accepting new patients |
Locations
4021 Cascade Rd SE
Ste 50
Grand Rapids, MI 49546
Phone (616) 974-9792
Organizations & group practices 2
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.
-
- Compounding Pharmacy
- Grand Rapids, MI
- NPI 1316049745
-
- Long Term Care Pharmacy
- Grand Rapids, MI
- NPI 1245942572
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536192000000",
"number": "1245712116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "KEYSTONE PHARMACY",
"address_2": "4021 CASCADE RD SE SUITE 50",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49546",
"telephone_number": "616-974-9792",
"fax_number": "616-464-3469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4021 CASCADE RD SE",
"address_2": "SUITE 50",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49546",
"telephone_number": "616-974-9792",
"fax_number": "616-464-3469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "DAVID",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "RPH, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-06",
"last_updated": "2018-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302027363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.