Active NPI
Kevin Walsh
- Pharmacist
- Davison, MI
National Provider Identifier
1285058883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302038011
- Practice address
- 901 S State Rd
Davison, MI 48423-1721 - Phone
- (810) 653-4020
- NPI assigned
- Feb 18, 2014
- Last updated
- Jan 26, 2016
- 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 | 5302038011 | MI | Primary |
Addresses
Primary practice location
901 S State Rd
Davison, MI 48423-1721
Mailing address
901 S State Rd
Davison, MI 48423-1721
Phone (810) 653-4020
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 |
|---|---|---|---|
| 5302038011 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Davison Pharmacy LLC | Current | Accepting new patients |
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": "1392681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453766400000",
"number": "1285058883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 S STATE RD",
"city": "DAVISON",
"state": "MI",
"postal_code": "484231721",
"telephone_number": "810-653-4020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 S STATE RD",
"city": "DAVISON",
"state": "MI",
"postal_code": "484231721",
"telephone_number": "810-653-4020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "KEVIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-02-18",
"last_updated": "2016-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302038011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Davison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.