Individual provider Active NPI

Michael John McNamara, RPH

  • Pharmacist
  • Gaylord, MI
National Provider Identifier
1376840165
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302024588 Issued in MI
Practice address
1151 S Otsego Ave
Gaylord, MI 49735-1789
Phone
(989) 732-8990
NPI assigned
Feb 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302024588 MI Primary

Addresses

Primary practice location

1151 S Otsego Ave
Gaylord, MI 49735-1789

Mailing address

615 S Roberts Rd
Grayling, MI 49738-7009
Phone (989) 348-7735

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
5302024588MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1376840165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S ROBERTS RD",
            "city": "GRAYLING",
            "state": "MI",
            "postal_code": "497387009",
            "telephone_number": "989-348-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 S OTSEGO AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351789",
            "telephone_number": "989-732-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNAMARA",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-15",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302024588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaylord, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.