Individual provider Active NPI

Michelle Spain, PHARMD

  • Pharmacist
  • High Point, NC
National Provider Identifier
1669760104
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19648 Issued in NC
Practice address
124 Montlieu Ave
High Point, NC 27262-4029
Phone
(336) 881-1050
Fax
(336) 889-8818
NPI assigned
Jul 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19648 NC Primary

Addresses

Primary practice location

124 Montlieu Ave
High Point, NC 27262-4029

Mailing address

20 Bearkling PL
Greensboro, NC 27407-6394
Phone (336) 617-3192

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
19648NCMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1669760104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BEARKLING PL",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274076394",
            "telephone_number": "336-617-3192",
            "fax_number": "336-889-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MONTLIEU AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272624029",
            "telephone_number": "336-881-1050",
            "fax_number": "336-889-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAIN",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "19648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.