Individual provider Active NPI

Mike McKie

  • Pharmacist
  • Perry, IA
National Provider Identifier
1558675983
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15056 Issued in IA
Practice address
1305 141St St
Perry, IA 50220-8128
Phone
(515) 465-5484
Fax
(515) 465-5488
NPI assigned
Jul 27, 2010
Last updated
Jul 27, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15056 IA Primary

Addresses

Primary practice location

1305 141St St
Perry, IA 50220-8128

Mailing address

1305 141St St
Perry, IA 50220-8128
Phone (515) 465-5484

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
15056IAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1558675983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 141ST ST",
            "city": "PERRY",
            "state": "IA",
            "postal_code": "502208128",
            "telephone_number": "515-465-5484",
            "fax_number": "515-465-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 141ST ST",
            "city": "PERRY",
            "state": "IA",
            "postal_code": "502208128",
            "telephone_number": "515-465-5484",
            "fax_number": "515-465-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIE",
        "first_name": "MIKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-27",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "15056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.