Active NPI
Grant E Severe, RPH
- Pharmacist
- Logan, UT
National Provider Identifier
1265074157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 147190
- Practice address
- 175 E 442 N
Logan, UT 84321 - Phone
- (435) 753-6570
- Fax
- (435) 750-0931
- NPI assigned
- Oct 11, 2019
- Sex
- Male
- 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 | 147190 | UT | Primary |
Addresses
Primary practice location
175 E 442 N
Logan, UT 84321
Mailing address
9 S 490 E
Smithfield, UT 84335-1221
Phone (435) 764-1559
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
| License | State | Type | Specialty |
|---|---|---|---|
| 147190 | UT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smiths Food & Drug Centers Inc | Past | Accepting new patients | |
| Smith'S Food & Drug Centers 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.
-
- Community/Retail Pharmacy
- Logan, UT
- NPI 1780601302
-
- Community/Retail Pharmacy
- Henderson, NV
- NPI 1881585248
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570752000000",
"number": "1265074157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 S 490 E",
"city": "SMITHFIELD",
"state": "UT",
"postal_code": "843351221",
"telephone_number": "435-764-1559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 E 442 N",
"city": "LOGAN",
"state": "UT",
"postal_code": "84321",
"telephone_number": "435-753-6570",
"fax_number": "435-750-0931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEVERE",
"first_name": "GRANT",
"middle_name": "E",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-11",
"last_updated": "2019-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "147190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.