NPIMap

Individual provider Active NPI

Robert Presley

  • Pharmacist
  • Clinton TWP, MI
National Provider Identifier
1790166148
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302032069 Issued in MI
Practice address
16100 19 Mile Rd
Clinton TWP, MI 48038-1148
Phone
(586) 221-4460
Fax
(586) 221-2547
NPI assigned
Jun 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302032069 MI Primary

Addresses

Primary practice location

16100 19 Mile Rd
Clinton TWP, MI 48038-1148

Mailing address

16100 19 Mile Rd
Clinton TWP, MI 48038-1148
Phone (586) 221-4460

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
5302032069MIMDPharmacist

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1790166148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16100 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381148",
            "telephone_number": "586-221-4460",
            "fax_number": "586-221-2547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16100 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381148",
            "telephone_number": "586-221-4460",
            "fax_number": "586-221-2547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESLEY",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302032069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.