Individual provider Active NPI

Phyllis Klonowski, RPH

  • Pharmacist
  • Saginaw, MI
National Provider Identifier
1316115306
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302022725 Issued in MI
Practice address
401 Holden St
Saginaw, MI 48601-2565
Phone
(989) 907-5602
Fax
(989) 907-5603
NPI assigned
Feb 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302022725 MI Primary

Addresses

Primary practice location

401 Holden St
Saginaw, MI 48601-2565

Mailing address

401 Holden St
Saginaw, MI 48601-2565
Phone (989) 907-5602

Other identifiers 1

IdentifierTypeStateIssuer
5302022725OtherMIPHARMACIST LICENSE

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
5302022725MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Prescription Support Program Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202860800000",
    "number": "1316115306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HOLDEN ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486012565",
            "telephone_number": "989-907-5602",
            "fax_number": "989-907-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HOLDEN ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486012565",
            "telephone_number": "989-907-5602",
            "fax_number": "989-907-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLONOWSKI",
        "first_name": "PHYLLIS",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302022725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "5302022725",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.