Active NPI
Michelle Marin
- Pharmacist
- Plymouth, MN
National Provider Identifier
1669988697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 122812
- Practice address
- 16705 County Road 24
Plymouth, MN 55447-1287 - Phone
- (763) 383-7061
- NPI assigned
- Dec 28, 2017
- Sex
- Female
- Sole proprietor
- No
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 | 122812 | MN | Primary |
Addresses
Primary practice location
16705 County Road 24
Plymouth, MN 55447-1287
Mailing address
8200 42ND Ave N
New Hope, MN 55427-1100
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 |
|---|---|---|---|
| 122812 | MN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650240000000",
"number": "1669988697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8200 42ND AVE N",
"city": "NEW HOPE",
"state": "MN",
"postal_code": "554271100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16705 COUNTY ROAD 24",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554471287",
"telephone_number": "763-383-7061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIN",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-28",
"last_updated": "2022-04-18",
"certification_date": "2022-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "122812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.