Active NPI
Tara Weaver
- Pharmacist
- Grand Ledge, MI
National Provider Identifier
1699066324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302024201
- Practice address
- 715 S Clinton St
Grand Ledge, MI 48837-2291 - Phone
- (517) 627-2800
- NPI assigned
- Apr 28, 2011
- 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 | 5302024201 | MI | Primary |
Addresses
Primary practice location
715 S Clinton St
Grand Ledge, MI 48837-2291
Mailing address
1137 Norfolk
Grand Ledge, MI 48837
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 |
|---|---|---|---|
| 5302024201 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rite Aid of Michigan Inc | Past | Accepting new patients | |
| Rite Aid of Michigan Inc | Past | Accepting new patients |
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.
-
dba Rite Aid Pharmacy 01530
- Community/Retail Pharmacy
- Grand Ledge, MI
- NPI 1215046750
-
dba Rite Aid Pharmacy 04068
- Community/Retail Pharmacy
- Washington, MI
- NPI 1619117405
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303948800000",
"number": "1699066324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1137 NORFOLK",
"city": "GRAND LEDGE",
"state": "MI",
"postal_code": "48837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 S CLINTON ST",
"city": "GRAND LEDGE",
"state": "MI",
"postal_code": "488372291",
"telephone_number": "517-627-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEAVER",
"first_name": "TARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-28",
"last_updated": "2011-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302024201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Ledge, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.