Individual provider Active NPI

Jeffrey Thomas McEvoy, PHARMD

  • Pharmacist
  • Sterling Heights, MI
National Provider Identifier
1669003521
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302034184 Issued in MI
Practice address
13475 15 Mile Rd
Sterling Heights, MI 48312-4214
Phone
(586) 268-2900
Fax
(586) 268-3478
NPI assigned
Jan 30, 2020
Last updated
Jan 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302034184 MI Primary

Addresses

Primary practice location

13475 15 Mile Rd
Sterling Heights, MI 48312-4214

Mailing address

13475 15 Mile Rd
Sterling Heights, MI 48312-4214
Phone (586) 268-2900

Other practice location 1

10652 Gratiot Ave
Detroit, MI 48213-1200
Phone (313) 571-0441

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

LicenseStateTypeSpecialty
5302034184MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Woodward Detroit CVS, L.L.C. PastSince Jan 31, 2021 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": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1669003521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13475 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483124214",
            "telephone_number": "586-268-2900",
            "fax_number": "586-268-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13475 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483124214",
            "telephone_number": "586-268-2900",
            "fax_number": "586-268-3478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10652 Gratiot Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482131200",
            "country_code": "US",
            "telephone_number": "313-571-0441",
            "fax_number": "313-571-0449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCEVOY",
        "first_name": "JEFFREY",
        "middle_name": "THOMAS",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-30",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302034184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.