Individual provider Active NPI

Daniel Jerik Scheltema

  • Pharmacist
  • Clinton Township, MI
National Provider Identifier
1548570849
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302039698 Issued in MI
Practice address
40925 Garfield Rd
Clinton Township, MI 48038-2537
Phone
(586) 263-4070
NPI assigned
Oct 20, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 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 5302039698 MI Primary

Addresses

Primary practice location

40925 Garfield Rd
Clinton Township, MI 48038-2537

Mailing address

49201 Cranbrook Dr
Macomb, MI 48044-1554
Phone (586) 506-6220

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

LicenseStateTypeSpecialty
5302039698MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1548570849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49201 CRANBROOK DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480441554",
            "telephone_number": "586-506-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40925 GARFIELD RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480382537",
            "telephone_number": "586-263-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHELTEMA",
        "first_name": "DANIEL",
        "middle_name": "JERIK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-20",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302039698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.