Individual provider Active NPI

Anne Marie Kozal, RPH

  • Pharmacist
  • Grand Rapids, MI
National Provider Identifier
1366508392
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302031100 Issued in MI
Practice address
2680 Leonard St NE
Grand Rapids, MI 49525-6934
Phone
(616) 224-1121
Fax
(616) 224-3001
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302031100 MI Primary

Addresses

Primary practice location

2680 Leonard St NE
Grand Rapids, MI 49525-6934

Mailing address

2680 Leonard St NE Ste 5
Grand Rapids, MI 49525-6901
Phone (616) 369-6401

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
5302031100MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Apc-D&S, LLC CurrentSince Mar 13, 2022 Accepting new patients

Locations

2680 Leonard St NE
Ste 5
Grand Rapids, MI 49525
Phone (616) 224-1121

2680 Leonard St NE
Grand Rapids, MI 49525
Phone (616) 224-1110

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1366508392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 LEONARD ST NE STE 5",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256901",
            "telephone_number": "616-369-6401",
            "fax_number": "616-315-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 LEONARD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256934",
            "telephone_number": "616-224-1121",
            "fax_number": "616-224-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAL",
        "first_name": "ANNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302031100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.

Verify at the official NPI Registry.