Active NPI
Kimberly Ann Proffer, PHARMD, RPH
- Pharmacist
- Lapeer, MI
National Provider Identifier
1316139603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302034187
- Practice address
- 15555 Demill Rd
Lapeer, MI 48446 - Phone
- (810) 667-8133
- NPI assigned
- Aug 10, 2007
- Sex
- Female
- 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 | 5302034187 | MI | Primary |
Addresses
Primary practice location
15555 Demill Rd
Lapeer, MI 48446
Mailing address
3279 W Barnes Lake Rd
Columbiaville, MI 48421-9364
Phone (810) 793-6803
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302034187 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186704000000",
"number": "1316139603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3279 W BARNES LAKE RD",
"city": "COLUMBIAVILLE",
"state": "MI",
"postal_code": "484219364",
"telephone_number": "810-793-6803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15555 DEMILL RD",
"city": "LAPEER",
"state": "MI",
"postal_code": "48446",
"telephone_number": "810-667-8133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROFFER",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PHARMD, RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-10",
"last_updated": "2007-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302034187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lapeer, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.