Active NPI
Terryl Ensign, R.PH
- Pharmacist
- Bangor, MI
National Provider Identifier
1770593147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302018624
- Practice address
- 211 W Monroe St
Bangor, MI 49013-1330 - Phone
- (269) 427-7706
- Fax
- (269) 427-5752
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302018624 | MI | Primary |
Addresses
Primary practice location
211 W Monroe St
Bangor, MI 49013-1330
Mailing address
115 Windmill Way
Battle Creek, MI 49017-3145
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302018624 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Pharmacy Inc | 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.
-
- Community/Retail Pharmacy
- Suttons Bay, MI
- NPI 1811904345
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770593147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 WINDMILL WAY",
"city": "BATTLE CREEK",
"state": "MI",
"postal_code": "490173145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 W MONROE ST",
"city": "BANGOR",
"state": "MI",
"postal_code": "490131330",
"telephone_number": "269-427-7706",
"fax_number": "269-427-5752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENSIGN",
"first_name": "TERRYL",
"name_prefix": "Mr.",
"credential": "R.PH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302018624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, MI
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.