Individual provider Active NPI

Michael Grumble, PHARMD

  • Pharmacist
  • Whitehall, OH
National Provider Identifier
1386179182
Registry record updated Apr 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03334820 Issued in OH
Practice address
3675 E Broad St
Whitehall, OH 43213-1124
Phone
(614) 239-0404
Fax
(614) 239-0431
NPI assigned
Apr 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03334820 OH Primary

Addresses

Primary practice location

3675 E Broad St
Whitehall, OH 43213-1124

Mailing address

3675 E Broad St
Whitehall, OH 43213-1124
Phone (614) 239-0404

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

State licenses

LicenseStateTypeSpecialty
03334820OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The Kroger Co Past Accepting new patients

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": "1493424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493424000000",
    "number": "1386179182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3675 E BROAD ST",
            "city": "WHITEHALL",
            "state": "OH",
            "postal_code": "432131124",
            "telephone_number": "614-239-0404",
            "fax_number": "614-239-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 E BROAD ST",
            "city": "WHITEHALL",
            "state": "OH",
            "postal_code": "432131124",
            "telephone_number": "614-239-0404",
            "fax_number": "614-239-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUMBLE",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-29",
        "last_updated": "2017-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03334820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitehall, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2017; 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.