Active NPI
Lon Steven Ruppel, RPH
- Pharmacist
- Fort Gratiot, MI
National Provider Identifier
1467903492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302026224
- Practice address
- 4845 24TH Ave
Fort Gratiot, MI 48059-3407 - Phone
- (810) 385-7747
- Fax
- (810) 385-4679
- NPI assigned
- Oct 14, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | 5302026224 | MI | Primary |
Addresses
Primary practice location
4845 24TH Ave
Fort Gratiot, MI 48059-3407
Mailing address
5880 S Bob White Drive
Kimball, MI 48074
Phone (810) 941-8286
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5302026224 | Other | MI | PHARMACIST LICENSE |
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302026224 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476403200000",
"number": "1467903492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5880 S BOB WHITE DRIVE",
"city": "KIMBALL",
"state": "MI",
"postal_code": "48074",
"telephone_number": "810-941-8286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4845 24TH AVE",
"city": "FORT GRATIOT",
"state": "MI",
"postal_code": "480593407",
"telephone_number": "810-385-7747",
"fax_number": "810-385-4679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUPPEL",
"first_name": "LON",
"middle_name": "STEVEN",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-10-14",
"last_updated": "2016-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302026224",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "5302026224",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Gratiot, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.