Individual provider Active NPI

Tammy Busch

  • Pharmacist
  • Gaylord, MI
National Provider Identifier
1710344676
Registry record updated Jan 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302029617 Issued in MI
Practice address
825 N Center Ave
Gaylord, MI 49735-1592
Phone
(989) 731-2163
Fax
(989) 731-2162
NPI assigned
Jan 24, 2016
Last updated
Jan 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302029617 MI Primary

Addresses

Primary practice location

825 N Center Ave
Gaylord, MI 49735-1592

Mailing address

2608 Krys Rd
Gaylord, MI 49735-8034
Phone (989) 350-4349

Other identifiers 1

IdentifierTypeStateIssuer
5171589MedicaidMI

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

LicenseStateTypeSpecialty
5302029617MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1453593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453593600000",
    "number": "1710344676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 KRYS RD",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497358034",
            "telephone_number": "989-350-4349",
            "fax_number": "989-731-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 N CENTER AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351592",
            "telephone_number": "989-731-2163",
            "fax_number": "989-731-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSCH",
        "first_name": "TAMMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-24",
        "last_updated": "2016-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302029617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5171589",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaylord, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2016; 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.