Active NPI
Michael Edward Roman, RPH
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Show Low, AZ
National Provider Identifier
1306202791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- S008861
- Practice address
- 1240 N 40TH Dr
Show Low, AZ 85901-3236 - Phone
- (928) 830-1571
- NPI assigned
- Jan 14, 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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | S008861 | AZ | Primary |
Addresses
Primary practice location
1240 N 40TH Dr
Show Low, AZ 85901-3236
Mailing address
1240 N 40TH Dr
Show Low, AZ 85901-3236
Phone (928) 830-1571
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
| License | State | Type | Specialty |
|---|---|---|---|
| S008861 | AZ | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452729600000",
"number": "1306202791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1240 N 40TH DR",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859013236",
"telephone_number": "928-830-1571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1240 N 40TH DR",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859013236",
"telephone_number": "928-830-1571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROMAN",
"first_name": "MICHAEL",
"middle_name": "EDWARD",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-01-14",
"last_updated": "2016-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "AZ",
"license": "S008861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Show Low, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.