Individual provider Active NPI

James Russell Proos, RPH

  • Pharmacist
  • Whitmore Lake, MI
National Provider Identifier
1720424211
Registry record updated May 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21722 Issued in MI
Practice address
11912 Whitmore Lake Rd
Whitmore Lake, MI 48189-9372
Phone
(734) 449-0004
Fax
(734) 449-0403
NPI assigned
May 11, 2013
Last updated
May 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21722 MI Primary

Addresses

Primary practice location

11912 Whitmore Lake Rd
Whitmore Lake, MI 48189-9372

Mailing address

3093 Dana Pointe Dr
Pinckney, MI 48169-8238
Phone (586) 212-0464

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
21722MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1368230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368230400000",
    "number": "1720424211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3093 DANA POINTE DR",
            "city": "PINCKNEY",
            "state": "MI",
            "postal_code": "481698238",
            "telephone_number": "586-212-0464",
            "fax_number": "734-449-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11912 WHITMORE LAKE RD",
            "city": "WHITMORE LAKE",
            "state": "MI",
            "postal_code": "481899372",
            "telephone_number": "734-449-0004",
            "fax_number": "734-449-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROOS",
        "first_name": "JAMES",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-11",
        "last_updated": "2013-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "21722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitmore Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2013; 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.