Active NPI
Michelle Lee
- Pharmacist
- Placerville, CA
National Provider Identifier
1376028696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 81454
- Practice address
- 3955 Missouri Flat Rd
Placerville, CA 95667-5208 - Phone
- (530) 295-2977
- NPI assigned
- Oct 2, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 38697 | CA | |
| Pharmacist | 183500000X | 81454 | CA | Primary |
Addresses
Primary practice location
3955 Missouri Flat Rd
Placerville, CA 95667-5208
Mailing address
4100 Forni Rd
Placerville, CA 95667-7001
Other practice location 1
7720 Lorraine Ave
Stockton, CA 95210-4203
Phone (530) 417-5588
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81454 | CA | MD | Pharmacist |
| 38697 | CA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Placerville, CA
- NPI 1437188471
-
- Community/Retail Pharmacy
- Queen Creek, AZ
- NPI 1730040973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576195200000",
"number": "1376028696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 FORNI RD",
"city": "PLACERVILLE",
"state": "CA",
"postal_code": "956677001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3955 MISSOURI FLAT RD",
"city": "PLACERVILLE",
"state": "CA",
"postal_code": "956675208",
"telephone_number": "530-295-2977"
}
],
"practiceLocations": [
{
"address_1": "7720 Lorraine Ave",
"address_purpose": "LOCATION",
"city": "Stockton",
"state": "CA",
"postal_code": "952104203",
"country_code": "US",
"telephone_number": "530-417-5588",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-02",
"last_updated": "2019-12-13",
"certification_date": "2019-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "38697",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "81454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Placerville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.