Active NPI
Michael Thomas Bane, PHARMD
- Pharmacist
- Newport News, VA
National Provider Identifier
1285041632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202213215
- Practice address
- 13007 Warwick Blvd
Newport News, VA 23602-8315 - Phone
- (757) 882-1074
- NPI assigned
- Jul 17, 2014
- Last updated
- Dec 21, 2022
- Sex
- Male
- 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 | 0202213215 | VA | Primary |
Addresses
Primary practice location
13007 Warwick Blvd
Newport News, VA 23602-8315
Mailing address
201 W 21St St Ste 6
Norfolk, VA 23517-2365
Phone (757) 278-2577
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0202213215 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
201 W 21st St
Ste 6
Norfolk, VA 23517
Phone (757) 278-2577
Organizations & group practices 3
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": "1405555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671580800000",
"number": "1285041632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 W 21ST ST STE 6",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235172365",
"telephone_number": "757-278-2577",
"fax_number": "757-278-2578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13007 WARWICK BLVD",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "236028315",
"telephone_number": "757-882-1074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANE",
"first_name": "MICHAEL",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-17",
"last_updated": "2022-12-21",
"certification_date": "2022-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202213215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport News, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.