Individual provider Active NPI

Marcia A Herrin, RPH

  • Pharmacist
  • Lady Lake, FL
National Provider Identifier
1366780686
Registry record updated Jan 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS20960 Issued in FL
Practice address
1566 Bella Cruz Dr
Lady Lake, FL 32159-8969
Phone
(352) 750-9863
Fax
(352) 751-2715
NPI assigned
Jan 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS20960 FL Primary

Addresses

Primary practice location

1566 Bella Cruz Dr
Lady Lake, FL 32159-8969

Mailing address

1566 Bella Cruz Dr
Lady Lake, FL 32159-8969
Phone (352) 750-9863

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
PS20960FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1358726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358726400000",
    "number": "1366780686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1566 BELLA CRUZ DR",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321598969",
            "telephone_number": "352-750-9863",
            "fax_number": "352-751-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1566 BELLA CRUZ DR",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321598969",
            "telephone_number": "352-750-9863",
            "fax_number": "352-751-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRIN",
        "first_name": "MARCIA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-21",
        "last_updated": "2013-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS20960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2013; 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.