Active NPI
John Kozemchak
- Pharmacist
- Roseville, MI
National Provider Identifier
1497209563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302029459
- Practice address
- 28804 Gratiot Ave
Roseville, MI 48066-4235 - Phone
- (586) 777-9475
- Fax
- (586) 777-3883
- NPI assigned
- Aug 6, 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 | 5302029459 | MI | Primary |
Addresses
Primary practice location
28804 Gratiot Ave
Roseville, MI 48066-4235
Mailing address
28804 Gratiot Ave
Roseville, MI 48066-4235
Phone (586) 777-9475
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 |
|---|---|---|---|
| 5302029459 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470441600000",
"number": "1497209563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28804 GRATIOT AVE",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "480664235",
"telephone_number": "586-777-9475",
"fax_number": "586-777-3883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28804 GRATIOT AVE",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "480664235",
"telephone_number": "586-777-9475",
"fax_number": "586-777-3883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOZEMCHAK",
"first_name": "JOHN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-06",
"last_updated": "2016-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302029459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MI
- David Kolman
- Rory Komlenovich
- Michael R Kornas, APRN-CNP
- Georgette Marie Kosmack, MSN FNP-C
- Mary G. Koukios, L.M.S.W.
- Dale Joseph Kretunski, P.T.
- Kroger Co of Michigan (Kroger Pharmacy #774)
- Kroger Co of Michigan (Kroger Pharmacy)
- Kroger Co of Michigan (Kroger Pharmacy)
- Pacharee Kulwattanaporn, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.