Active NPI
Jack W. Urben, PHARM.D.
- Pharmacotherapy Pharmacist
- Kentwood, MI
National Provider Identifier
1699771485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 5302021538
- Practice address
- 3031 Poplar Creek Dr SE
Unit 103
Kentwood, MI 49512-5667 - Phone
- (616) 949-9573
- Fax
- (616) 975-7596
- NPI assigned
- Jun 26, 2005
- 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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 5302021538 | MI | Primary |
Addresses
Primary practice location
3031 Poplar Creek Dr SE
Unit 103
Kentwood, MI 49512-5667
Mailing address
3031 Poplar Creek Dr SE
Unit 103
Kentwood, MI 49512-5667
Phone (616) 949-9573
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302021538 | MI | MD | Pharmacotherapy Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cosalus Health PLLC | Past | 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 and National Provider Directory roles.
-
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Grand Rapids, MI
- NPI 1003152752
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699771485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3031 POPLAR CREEK DR SE",
"address_2": "UNIT 103",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495125667",
"telephone_number": "616-949-9573",
"fax_number": "616-975-7596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3031 POPLAR CREEK DR SE",
"address_2": "UNIT 103",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495125667",
"telephone_number": "616-949-9573",
"fax_number": "616-975-7596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "URBEN",
"first_name": "JACK",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MI",
"license": "5302021538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kentwood, MI
- Uneven Lotus Yoga, LLC
- United Hearts Home Care, LLC
- United Pharmaceutical Services Inc.
- Unity Senior Care LLC
- Courtney Albin Upchurch, MAC, LPC, CAADC
- Madissen Anne Vacha, M.S., CCC-SLP
- Peter Jeffrey Vance, M.D.
- Jaqueline Regina Vandenberg, BEHAVIOR TECHNICIAN
- Julia Lynn Vandenbosch, LMSW
- Marie Vander Linde, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.