Individual provider Active NPI

Joseph Stenberg, PHARMD

  • Pharmacist
  • Jackson, MI
National Provider Identifier
1487255964
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302041453 Issued in MI
Practice address
1700 W Michigan Ave
Jackson, MI 49202-4005
Phone
(517) 817-0378
Fax
(517) 817-0385
NPI assigned
Nov 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 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 5302041453 MI Primary

Addresses

Primary practice location

1700 W Michigan Ave
Jackson, MI 49202-4005

Mailing address

3710 Ryan Dr
Dexter, MI 48130-9230
Phone (734) 882-9082

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
5302041453MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1487255964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 RYAN DR",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481309230",
            "telephone_number": "734-882-9082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492024005",
            "telephone_number": "517-817-0378",
            "fax_number": "517-817-0385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STENBERG",
        "first_name": "JOSEPH",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-03",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302041453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.