Active NPI
Thomas Allen Stavenger, RPH
- Pharmacist
- Brighton, MI
National Provider Identifier
1659697274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11727
- Practice address
- 1111 Mildred J CT
Brighton, MI 48116-3792 - Phone
- (810) 220-4426
- NPI assigned
- Apr 8, 2010
- 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 | 11727 | MN | Primary |
Addresses
Primary practice location
1111 Mildred J CT
Brighton, MI 48116-3792
Mailing address
1111 Mildred J CT
Brighton, MI 48116-3792
Phone (810) 220-4426
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270684800000",
"number": "1659697274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 MILDRED J CT",
"city": "BRIGHTON",
"state": "MI",
"postal_code": "481163792",
"telephone_number": "810-220-4426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 MILDRED J CT",
"city": "BRIGHTON",
"state": "MI",
"postal_code": "481163792",
"telephone_number": "810-220-4426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAVENGER",
"first_name": "THOMAS",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-08",
"last_updated": "2010-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "11727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brighton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.