Active NPI
Mary Helen Nedry, RPH
- Pharmacist
- Middleville, MI
National Provider Identifier
1497739197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302033226
- Practice address
- 4652 N M 37 Hwy
Middleville, MI 49333-8806 - Phone
- (269) 795-7936
- NPI assigned
- Dec 6, 2005
- Last updated
- Jul 9, 2007
- Sex
- Female
- 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 | 5302033226 | MI | Primary |
Addresses
Primary practice location
4652 N M 37 Hwy
Middleville, MI 49333-8806
Mailing address
909 W Main St
Middleville, MI 49333-9770
Phone (269) 795-3166
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1964469 | Medicaid | MI | |
| 2540648 | Medicaid | MI | |
| 5302033226 | Other | MI | REG. 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 |
|---|---|---|---|
| 5302033226 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pci Pharmacy, Inc | Past | Accepting new patients | |
| Pci Pharmacy, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1497739197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 W MAIN ST",
"city": "MIDDLEVILLE",
"state": "MI",
"postal_code": "493339770",
"telephone_number": "269-795-3166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4652 N M 37 HWY",
"city": "MIDDLEVILLE",
"state": "MI",
"postal_code": "493338806",
"telephone_number": "269-795-7936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEDRY",
"first_name": "MARY",
"middle_name": "HELEN",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-12-06",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302033226",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1964469",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2540648",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REG. PHARMACIST LICENSE",
"identifier": "5302033226",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Middleville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.