Active NPI
Stacy Smith
- Pharmacist
- Detroit, MI
National Provider Identifier
1417336066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302029069
- Practice address
- 7430 2ND Ave
Detroit, MI 48202-2739 - Phone
- (313) 670-7621
- NPI assigned
- May 28, 2015
- Last updated
- May 28, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302029069 | MI | Primary |
Addresses
Primary practice location
7430 2ND Ave
Detroit, MI 48202-2739
Mailing address
9931 Lapham Way
Plymouth, MI 48170-5853
Phone (734) 777-8397
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302029069 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432771200000",
"number": "1417336066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9931 LAPHAM WAY",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481705853",
"telephone_number": "734-777-8397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7430 2ND AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022739",
"telephone_number": "313-670-7621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "STACY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-28",
"last_updated": "2015-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302029069",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.