Active NPI
Kyle Erickson
- Pharmacist
- Novi, MI
National Provider Identifier
1629856802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302041257
- Practice address
- 21897 Worcester Dr
Novi, MI 48374-3954 - Phone
- (517) 980-1914
- NPI assigned
- Sep 19, 2023
- Sex
- Male
- 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 | 5302041257 | MI | Primary |
Addresses
Primary practice location
21897 Worcester Dr
Novi, MI 48374-3954
Mailing address
21897 Worcester Dr
Novi, MI 48374-3954
Phone (517) 980-1914
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 |
|---|---|---|---|
| 5302041257 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695081600000",
"number": "1629856802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21897 WORCESTER DR",
"city": "NOVI",
"state": "MI",
"postal_code": "483743954",
"telephone_number": "517-980-1914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21897 WORCESTER DR",
"city": "NOVI",
"state": "MI",
"postal_code": "483743954",
"telephone_number": "517-980-1914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERICKSON",
"first_name": "KYLE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-19",
"last_updated": "2023-09-19",
"certification_date": "2023-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302041257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Novi, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.