Individual provider Active NPI

Olivier Ishimwe, PHARMD

  • Pharmacist
  • Lansing, MI
National Provider Identifier
1407522162
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302413672 Issued in MI
Practice address
3106 E Saginaw St
Lansing, MI 48912-4712
Phone
(517) 337-1681
NPI assigned
Aug 20, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 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 5302413672 MI Primary

Addresses

Primary practice location

3106 E Saginaw St
Lansing, MI 48912-4712

Mailing address

411 Briar LN NE
Grand Rapids, MI 49503-2120
Phone (574) 302-6066

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
5302413672MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Michigan Inc PastSince Aug 28, 2021 Accepting new patients
Rite Aid of Michigan Inc PastSince Aug 28, 2021 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": "1629417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1407522162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 BRIAR LN NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032120",
            "telephone_number": "574-302-6066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 E SAGINAW ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489124712",
            "telephone_number": "517-337-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHIMWE",
        "first_name": "OLIVIER",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302413672",
            "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 Aug 20, 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.