Active NPI
Kris Cavanaugh
- Pharmacist
- Lapeer, MI
National Provider Identifier
1275310039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302025426
- Practice address
- 571 S Main St
Lapeer, MI 48446-2466 - Phone
- (810) 538-0014
- NPI assigned
- Sep 13, 2023
- Sex
- Female
- 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 | 5302025426 | MI | Primary |
Addresses
Primary practice location
571 S Main St
Lapeer, MI 48446-2466
Mailing address
3201 Walnut Hill Rd
Metamora, MI 48455-8929
Phone (810) 441-4663
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 |
|---|---|---|---|
| 5302025426 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients |
Locations
571 S Main St
Lapeer, MI 48446
Phone (810) 538-0014
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": "1694563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694563200000",
"number": "1275310039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3201 WALNUT HILL RD",
"city": "METAMORA",
"state": "MI",
"postal_code": "484558929",
"telephone_number": "810-441-4663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "571 S MAIN ST",
"city": "LAPEER",
"state": "MI",
"postal_code": "484462466",
"telephone_number": "810-538-0014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVANAUGH",
"first_name": "KRIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-13",
"last_updated": "2023-09-13",
"certification_date": "2023-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302025426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lapeer, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.