Active NPI
Rachel Catherine Pisacreta, RPH
- Pharmacist
- Grand Rapids, MI
National Provider Identifier
1609108943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302034642
- Practice address
- 4111 N Kent Mall NE
Grand Rapids, MI 49525-1633 - Phone
- (616) 364-6147
- Fax
- (616) 364-6479
- NPI assigned
- Feb 11, 2010
- Last updated
- Feb 12, 2010
- Sex
- Female
- 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 | 5302034642 | MI | Primary |
Addresses
Primary practice location
4111 N Kent Mall NE
Grand Rapids, MI 49525-1633
Mailing address
4111 N Kent Mall NE
Grand Rapids, MI 49525-1633
Phone (616) 364-6147
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5302034642 | Other | MI | PHARMACY LICENSE NUMBER |
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302034642 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265932800000",
"number": "1609108943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4111 N KENT MALL NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495251633",
"telephone_number": "616-364-6147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4111 N KENT MALL NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495251633",
"telephone_number": "616-364-6147",
"fax_number": "616-364-6479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PISACRETA",
"first_name": "RACHEL",
"middle_name": "CATHERINE",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-11",
"last_updated": "2010-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302034642",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE NUMBER",
"identifier": "5302034642",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.