Active NPI
Michelle A Davis, RPH
- Pharmacist
- Stony Brook, NY
National Provider Identifier
1518399641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 058329
- Practice address
- 101 Nicolls Rd
Stony Brook, NY 11794-0001 - Phone
- (631) 444-7714
- NPI assigned
- Jul 31, 2013
- Sex
- Female
- Sole proprietor
- No
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 | 058329 | NY | Primary |
Addresses
Primary practice location
101 Nicolls Rd
Stony Brook, NY 11794-0001
Mailing address
4202 Townehouse Dr
Coram, NY 11727-2800
Phone (631) 974-9157
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 |
|---|---|---|---|
| 058329 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375228800000",
"number": "1518399641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4202 TOWNEHOUSE DR",
"city": "CORAM",
"state": "NY",
"postal_code": "117272800",
"telephone_number": "631-974-9157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 NICOLLS RD",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117940001",
"telephone_number": "631-444-7714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MICHELLE",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-31",
"last_updated": "2013-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "058329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.