Individual provider Active NPI

Jaime Catherine Spellman, PHARMD

  • Pharmacotherapy Pharmacist
  • Waterford, MI
National Provider Identifier
1578642765
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
5302033595 Issued in MI
Practice address
4000 Highland Rd
Suite 113
Waterford, MI 48328-2167
Phone
(248) 977-1394
Fax
(248) 977-1395
NPI assigned
Nov 6, 2006
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302033595 MI
Pharmacotherapy Pharmacist 1835P1200X 5302033595 MI Primary

Addresses

Primary practice location

4000 Highland Rd
Suite 113
Waterford, MI 48328-2167

Mailing address

4000 Highland Rd
Suite 113
Waterford, MI 48328-2167
Phone (866) 850-6567

Other names 1

  • Ms. Jaime Catherine Poma Former name

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302033595MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1578642765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 HIGHLAND RD",
            "address_2": "SUITE 113",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282167",
            "telephone_number": "866-850-6567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 HIGHLAND RD",
            "address_2": "SUITE 113",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282167",
            "telephone_number": "248-977-1394",
            "fax_number": "248-977-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPELLMAN",
        "first_name": "JAIME",
        "middle_name": "CATHERINE",
        "name_prefix": "Ms.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302033595",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MI",
            "license": "5302033595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIME",
            "last_name": "POMA",
            "middle_name": "CATHERINE",
            "prefix": "MS.",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.