Michelle Addison

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

020747 Issued in KY

Practice address

1010 Main St S
MC Kee, KY 40447-7089

Phone

(606) 287-7104

Fax

(606) 287-3348

NPI assigned

Dec 13, 2021

Last updated

Dec 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1760141188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 MAIN ST S",
            "city": "MC KEE",
            "state": "KY",
            "postal_code": "404477089",
            "telephone_number": "606-287-7104",
            "fax_number": "606-287-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 MAIN ST S",
            "city": "MC KEE",
            "state": "KY",
            "postal_code": "404477089",
            "telephone_number": "606-287-7104",
            "fax_number": "606-287-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDISON",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "KY",
            "license": "020747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Blooming Oak Therapy, LLC

• Ambulatory Care Pharmacist in McKee, KY
• Providers in McKee, KY by specialty
• Ambulatory Care Pharmacist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.