Active NPI
Michelle Elan Decker
- Pharmacist
- Ravenna, OH
National Provider Identifier
1457013385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03129337
- Practice address
- 909 E Main St
Ravenna, OH 44266-3325 - Phone
- (330) 297-7366
- NPI assigned
- Oct 7, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP443995 | PA | |
| Pharmacist | 183500000X | 03129337 | OH | Primary |
Addresses
Primary practice location
909 E Main St
Ravenna, OH 44266-3325
Mailing address
909 E Main St
Ravenna, OH 44266-3325
Phone (330) 297-7366
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 |
|---|---|---|---|
| 03129337 | OH | MD | Pharmacist |
| RP443995 | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633564800000",
"number": "1457013385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 E MAIN ST",
"city": "RAVENNA",
"state": "OH",
"postal_code": "442663325",
"telephone_number": "330-297-7366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 E MAIN ST",
"city": "RAVENNA",
"state": "OH",
"postal_code": "442663325",
"telephone_number": "330-297-7366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECKER",
"first_name": "MICHELLE",
"middle_name": "ELAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-07",
"last_updated": "2021-10-07",
"certification_date": "2021-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP443995",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03129337",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ravenna, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.