Active NPI
Mark Thomas Johnson, PHARMD
- Pharmacist
- Chelsea, MI
National Provider Identifier
1619273265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302033721
- Practice address
- 935 S Main St
Chelsea, MI 48118-1330 - Phone
- (734) 475-2222
- Fax
- (734) 475-9268
- NPI assigned
- Jan 31, 2011
- Sex
- Male
- 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 | 5302033721 | MI | Primary |
Addresses
Primary practice location
935 S Main St
Chelsea, MI 48118-1330
Mailing address
935 S Main St
Chelsea, MI 48118-1330
Phone (734) 475-2222
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302033721 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodward Detroit CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580601600000",
"number": "1619273265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "935 S MAIN ST",
"city": "CHELSEA",
"state": "MI",
"postal_code": "481181330",
"telephone_number": "734-475-2222",
"fax_number": "734-475-9268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "935 S MAIN ST",
"city": "CHELSEA",
"state": "MI",
"postal_code": "481181330",
"telephone_number": "734-475-2222",
"fax_number": "734-475-9268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MARK",
"middle_name": "THOMAS",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-31",
"last_updated": "2020-02-02",
"certification_date": "2020-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302033721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chelsea, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.