Active NPI
Imtiaz Ahmad
- Pharmacist
- Clare, MI
National Provider Identifier
1538877576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21240020802
- Practice address
- 1141 N McEwan St
Clare, MI 48617-1107 - Phone
- (989) 386-6197
- NPI assigned
- Nov 8, 2022
- Sex
- Male
- 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 | 21240020802 | MI | Primary |
Addresses
Primary practice location
1141 N McEwan St
Clare, MI 48617-1107
Mailing address
1637 E Broomfield St Apt 3H
Mount Pleasant, MI 48858-5422
Phone (204) 999-1578
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | NA |
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 |
|---|---|---|---|
| 21240020802 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1141 N McEwan St
Clare, MI 48617
Phone (989) 386-6197
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667865600000",
"number": "1538877576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1637 E BROOMFIELD ST APT 3H",
"city": "MOUNT PLEASANT",
"state": "MI",
"postal_code": "488585422",
"telephone_number": "204-999-1578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1141 N MCEWAN ST",
"city": "CLARE",
"state": "MI",
"postal_code": "486171107",
"telephone_number": "989-386-6197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMAD",
"first_name": "IMTIAZ",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-08",
"last_updated": "2022-11-08",
"certification_date": "2022-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "21240020802",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "NA",
"affiliation": "N",
"address_1": "1141 N McEwan St",
"city": "Clare",
"state": "MI",
"country_code": "US",
"postal_code": "486171107",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Clare, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.