Active NPI
Ryan Boyd
- Community/Retail Pharmacy
- Livonia, MI
National Provider Identifier
1659968519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 5302413030
- Practice address
- 17001 Newburgh Rd
Livonia, MI 48154-1610 - Phone
- (734) 462-1707
- NPI assigned
- Dec 28, 2020
- 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 |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 5302413030 | MI | Primary |
Addresses
Primary practice location
17001 Newburgh Rd
Livonia, MI 48154-1610
Mailing address
1080 Kronner Rd
Columbus, MI 48063-2200
Phone (810) 305-2189
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 |
|---|---|---|---|
| 5302413030 | MI | MD | Community/Retail Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Community/Retail Pharmacy | Current | Accepting new patients |
| Walgreen Co | Community/Retail Pharmacy | Past | Accepting new patients |
Locations
17001 Newburgh Rd
Livonia, MI 48154
Phone (734) 462-1707
Organizations & group practices 2
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": "1609113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609113600000",
"number": "1659968519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1080 KRONNER RD",
"city": "COLUMBUS",
"state": "MI",
"postal_code": "480632200",
"telephone_number": "810-305-2189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17001 NEWBURGH RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481541610",
"telephone_number": "734-462-1707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "RYAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-28",
"last_updated": "2020-12-28",
"certification_date": "2020-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MI",
"license": "5302413030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.