Individual provider Active NPI

Matt Burton

  • Pharmacist
  • Lansing, MI
National Provider Identifier
1407221856
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302411002 Issued in MI
Practice address
340 E Edgewood Blvd
Lansing, MI 48911-5807
Phone
(517) 882-1142
Fax
(517) 882-1172
NPI assigned
Dec 10, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302411002 MI Primary

Addresses

Primary practice location

340 E Edgewood Blvd
Lansing, MI 48911-5807

Mailing address

340 E Edgewood Blvd
Lansing, MI 48911-5807
Phone (517) 882-1142

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

LicenseStateTypeSpecialty
5302411002MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1407221856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 E EDGEWOOD BLVD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489115807",
            "telephone_number": "517-882-1142",
            "fax_number": "517-882-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 E EDGEWOOD BLVD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489115807",
            "telephone_number": "517-882-1142",
            "fax_number": "517-882-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTON",
        "first_name": "MATT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302411002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.