Individual provider Active NPI

Macey Raelynn Hanel, PHARMD

  • Pharmacist
  • Fargo, ND
National Provider Identifier
1477164762
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH6135 Issued in ND
Practice address
2400 32ND Ave S Ste 4
Fargo, ND 58103-5804
Phone
(701) 234-9912
NPI assigned
Aug 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH6135 ND Primary

Addresses

Primary practice location

2400 32ND Ave S Ste 4
Fargo, ND 58103-5804

Mailing address

2400 32ND Ave S Ste 4
Fargo, ND 58103-5804
Phone (701) 234-9912

Other practice location 1

2701 13th Ave S
Fargo, ND 58103-3602
Phone (701) 234-3630

Other practice location 2

4776 31st Ave S Ste 105
Fargo, ND 58104
Phone (701) 639-6969

Other names 1

  • Macey Raelynn Llewellyn Former name

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
RPH6135NDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1477164762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 32ND AVE S STE 4",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581035804",
            "telephone_number": "701-234-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 32ND AVE S STE 4",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581035804",
            "telephone_number": "701-234-9912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 13th Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581033602",
            "country_code": "US",
            "telephone_number": "701-234-3630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4776 31st Ave S Ste 105",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "58104",
            "country_code": "US",
            "telephone_number": "701-639-6969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANEL",
        "first_name": "MACEY",
        "middle_name": "RAELYNN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "RPH6135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACEY",
            "last_name": "LLEWELLYN",
            "middle_name": "RAELYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.