Individual provider Active NPI

Nikota Daniel Redmond, PHARMD

  • Student in an Organized Health Care Education/Training Program
  • Grand Rapids, MI
National Provider Identifier
1700512464
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2425 Alpine Ave NW
Grand Rapids, MI 49544-1956
Phone
(616) 365-6010
NPI assigned
Jul 26, 2022
Reactivated
Jul 25, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI Primary

Addresses

Primary practice location

2425 Alpine Ave NW
Grand Rapids, MI 49544-1956

Mailing address

912 Baraga St NE
Grand Rapids, MI 49503-1803
Phone (517) 852-4296

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nikota.redmond@meijer.com Direct

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

NPI Registry JSON

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1700512464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 BARAGA ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031803",
            "telephone_number": "517-852-4296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 ALPINE AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495441956",
            "telephone_number": "616-365-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDMOND",
        "first_name": "NIKOTA",
        "middle_name": "DANIEL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-26",
        "last_updated": "2025-07-25",
        "certification_date": "2023-07-27",
        "deactivation_date": "2023-07-27",
        "reactivation_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nikota.redmond@meijer.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2425 Alpine Ave NW",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495441956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.