Individual provider Active NPI

Michele Rollins, RPH

  • Pharmacist
  • Old Saybrook, CT
National Provider Identifier
1407398068
Registry record updated Jan 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8014 Issued in CT
Practice address
105 Elm St
Old Saybrook, CT 06475-4132
Phone
(860) 388-6461
Fax
(844) 411-6478
NPI assigned
Nov 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8014 CT Primary

Addresses

Primary practice location

105 Elm St
Old Saybrook, CT 06475-4132

Mailing address

105 Elm St
Old Saybrook, CT 06475-4132
Phone (860) 388-6461

Other practice location 1

35 Shunpike Rd
Cromwell, CT 06416-2414
Phone (860) 635-6303

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
8014CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Stop and Shop Supermarket Co LLC Past Accepting new patients
The Stop & Shop Supermarket Company LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610150400000",
    "number": "1407398068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 ELM ST",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754132",
            "telephone_number": "860-388-6461",
            "fax_number": "844-411-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ELM ST",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064754132",
            "telephone_number": "860-388-6461",
            "fax_number": "844-411-6478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Shunpike Rd",
            "address_purpose": "LOCATION",
            "city": "Cromwell",
            "state": "CT",
            "postal_code": "064162414",
            "country_code": "US",
            "telephone_number": "860-635-6303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLLINS",
        "first_name": "MICHELE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2021-01-09",
        "certification_date": "2021-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "8014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Saybrook, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2021; 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.