Individual provider Active NPI

Michelle Renee Roseblock, PHARMD

  • Pharmacist
  • Independence, MO
National Provider Identifier
1588315246
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2009027315 Issued in MO
Practice address
4545 S Noland Rd
Independence, MO 64055-4887
Phone
(816) 478-1968
Fax
(816) 478-5649
NPI assigned
Jan 14, 2022
Last updated
Jan 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2009027315 MO Primary

Addresses

Primary practice location

4545 S Noland Rd
Independence, MO 64055-4887

Mailing address

18411 E Highland Dr
Pleasant Hill, MO 64080-7515
Phone (816) 674-3634

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
2009027315MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1588315246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18411 E HIGHLAND DR",
            "city": "PLEASANT HILL",
            "state": "MO",
            "postal_code": "640807515",
            "telephone_number": "816-674-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 S NOLAND RD",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640554887",
            "telephone_number": "816-478-1968",
            "fax_number": "816-478-5649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBLOCK",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2009027315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.

Verify at the official NPI Registry.