Active NPI
Roxanne Michelle Delisle, CPHT, LPHT
- Pharmacy Technician
- Otisville, MI
National Provider Identifier
1467150607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 5303032567
- Practice address
- 337 N State Rd
Otisville, MI 48463-9486 - Phone
- (810) 631-4551
- NPI assigned
- Feb 17, 2023
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 5303032567 | MI | Primary |
Addresses
Primary practice location
337 N State Rd
Otisville, MI 48463-9486
Mailing address
134 Summit Dr
Lapeer, MI 48446-1400
Phone (810) 610-9784
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1435854 | Other | MI | NABP |
| 5303032567 | Other | MI | LARA |
| 30111877 | Other | MI | PTCB |
Other names 1
- Roxanne Michelle Kreiner
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 |
|---|---|---|---|
| 5303032567 | MI | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rite Aid of Michigan Inc | Past | Accepting new patients | |
| Rite Aid of Michigan Inc | 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.
-
- Community/Retail Pharmacy
- Washington, MI
- NPI 1619117405
-
- Community/Retail Pharmacy
- Otisville, MI
- NPI 1932218492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676592000000",
"number": "1467150607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 SUMMIT DR",
"city": "LAPEER",
"state": "MI",
"postal_code": "484461400",
"telephone_number": "810-610-9784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "337 N STATE RD",
"city": "OTISVILLE",
"state": "MI",
"postal_code": "484639486",
"telephone_number": "810-631-4551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELISLE",
"first_name": "ROXANNE",
"middle_name": "MICHELLE",
"credential": "CPHT, LPHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-17",
"last_updated": "2023-02-17",
"certification_date": "2023-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "MI",
"license": "5303032567",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "1435854",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LARA",
"identifier": "5303032567",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTCB",
"identifier": "30111877",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ROXANNE",
"last_name": "KREINER",
"middle_name": "MICHELLE",
"credential": "CPHT, LPHT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Otisville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.