Individual provider Active NPI

Keith James Haddix Jr., RPH

  • Pharmacist
  • Trenton, MI
National Provider Identifier
1619215522
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302023034 Issued in MI
Practice address
2801 W Jefferson Ave
Trenton, MI 48183-2901
Phone
(734) 676-3784
NPI assigned
Jan 28, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302023034 MI Primary

Addresses

Primary practice location

2801 W Jefferson Ave
Trenton, MI 48183-2901

Mailing address

2801 W Jefferson
Trenton, MI 48183
Phone (734) 676-3784

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

LicenseStateTypeSpecialty
5302023034MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1619215522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W JEFFERSON",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "48183",
            "telephone_number": "734-676-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W JEFFERSON AVE",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481832901",
            "telephone_number": "734-676-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDIX",
        "first_name": "KEITH",
        "middle_name": "JAMES",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-28",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302023034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.