Individual provider Active NPI

Timothy George Kanan, RPH

  • Pharmacist
  • Auburn Hills, MI
National Provider Identifier
1275828485
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302024723 Issued in MI
Practice address
650 Brown Rd
T-1251
Auburn Hills, MI 48326-1307
Phone
(248) 393-8114
Fax
(248) 393-8114
NPI assigned
Jun 15, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302024723 MI Primary

Addresses

Primary practice location

650 Brown Rd
T-1251
Auburn Hills, MI 48326-1307

Mailing address

650 Brown Rd
T-1251
Auburn Hills, MI 48326-1307
Phone (248) 393-8114

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

LicenseStateTypeSpecialty
5302024723MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1275828485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 BROWN RD",
            "address_2": "T-1251",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483261307",
            "telephone_number": "248-393-8114",
            "fax_number": "248-393-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 BROWN RD",
            "address_2": "T-1251",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483261307",
            "telephone_number": "248-393-8114",
            "fax_number": "248-393-8114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAN",
        "first_name": "TIMOTHY",
        "middle_name": "GEORGE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-15",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302024723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.

Verify at the official NPI Registry.