Active NPI
Michelle Marie Neely
- Pharmacist
- Ladera Ranch, CA
National Provider Identifier
1619490109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 51839
- Practice address
- 27702 Crown Valley Pkwy Ste I
Ladera Ranch, CA 92694-0609 - Phone
- (949) 364-1430
- NPI assigned
- Jul 17, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 51839 | CA | Primary |
Addresses
Primary practice location
27702 Crown Valley Pkwy Ste I
Ladera Ranch, CA 92694-0609
Mailing address
3007 Calle Arco
San Clemente, CA 92672-3607
Phone (949) 510-9649
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51839 | CA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach 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": "1500249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500249600000",
"number": "1619490109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3007 CALLE ARCO",
"city": "SAN CLEMENTE",
"state": "CA",
"postal_code": "926723607",
"telephone_number": "949-510-9649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27702 CROWN VALLEY PKWY STE I",
"city": "LADERA RANCH",
"state": "CA",
"postal_code": "926940609",
"telephone_number": "949-364-1430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEELY",
"first_name": "MICHELLE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-17",
"last_updated": "2017-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "51839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ladera Ranch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.