Individual provider Active NPI

Gabrielle Smith, PHARMD

  • Community/Retail Pharmacy
  • Marquette, MI
National Provider Identifier
1417511981
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5302041262 Issued in MI
Practice address
1414 W Fair Ave Ste 133
Marquette, MI 49855-5408
Phone
(906) 225-3902
NPI assigned
Apr 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5302041262 MI Primary

Addresses

Primary practice location

1414 W Fair Ave Ste 133
Marquette, MI 49855-5408

Mailing address

1414 W Fair Ave Ste 133
Marquette, MI 49855-5408
Phone (906) 225-3902

Other practice location 1

300 N McClellan Ave
Marquette, MI 49855-3920
Phone (906) 225-1450

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
5302041262MIMDCommunity/Retail Pharmacy

NPI Registry JSON

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1417511981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE STE 133",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498555408",
            "telephone_number": "906-225-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE STE 133",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498555408",
            "telephone_number": "906-225-3902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 N McClellan Ave",
            "address_purpose": "LOCATION",
            "city": "Marquette",
            "state": "MI",
            "postal_code": "498553920",
            "country_code": "US",
            "telephone_number": "906-225-1450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GABRIELLE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5302041262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.