Individual provider Active NPI

Samantha Marie Willick, PHARM D

  • Pharmacist
  • Spring Lake, MI
National Provider Identifier
1255505467
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302034597 Issued in MI
Practice address
603 E Savidge St
Spring Lake, MI 49456-1956
Phone
(616) 842-1461
NPI assigned
Apr 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302034597 MI Primary

Addresses

Primary practice location

603 E Savidge St
Spring Lake, MI 49456-1956

Mailing address

603 E Savidge St
Spring Lake, MI 49456-1956
Phone (616) 842-1461

Other names 1

  • Dr. Samantha Marie Freeman Former name

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
5302034597MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Michigan Inc Past Accepting new patients
Rite Aid of Michigan Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1255505467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 E SAVIDGE ST",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494561956",
            "telephone_number": "616-842-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 E SAVIDGE ST",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494561956",
            "telephone_number": "616-842-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLICK",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302034597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "FREEMAN",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "PHARM D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spring Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.