Individual provider Active NPI

Ian Kempisty, PHARMD, RPH

  • Pharmacist
  • Marysville, MI
National Provider Identifier
1275900045
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302040765 Issued in MI
Practice address
205 S Range Rd
Marysville, MI 48040-2605
Phone
(810) 388-9610
Fax
(810) 388-9665
NPI assigned
Aug 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302040765 MI Primary

Addresses

Primary practice location

205 S Range Rd
Marysville, MI 48040-2605

Mailing address

35433 Edmunds GRV
New Baltimore, MI 48047-1198
Phone (586) 764-0891

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, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302040765MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1275900045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35433 EDMUNDS GRV",
            "city": "NEW BALTIMORE",
            "state": "MI",
            "postal_code": "480471198",
            "telephone_number": "586-764-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S RANGE RD",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480402605",
            "telephone_number": "810-388-9610",
            "fax_number": "810-388-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMPISTY",
        "first_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302040765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.