Active NPI
Traci Yates
- Pharmacotherapy Pharmacist
- Bay City, MI
National Provider Identifier
1790195006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 5302029434
- Practice address
- 2980 Wilder Rd
Bay City, MI 48706-9213 - Phone
- (989) 667-9533
- NPI assigned
- May 8, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 5302029434 | MI | Primary |
Addresses
Primary practice location
2980 Wilder Rd
Bay City, MI 48706-9213
Mailing address
609 Park Ave
Bay City, MI 48708-6859
Phone (989) 893-7392
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302029434 | MI | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399507200000",
"number": "1790195006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 PARK AVE",
"city": "BAY CITY",
"state": "MI",
"postal_code": "487086859",
"telephone_number": "989-893-7392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2980 WILDER RD",
"city": "BAY CITY",
"state": "MI",
"postal_code": "487069213",
"telephone_number": "989-667-9533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YATES",
"first_name": "TRACI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-08",
"last_updated": "2014-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MI",
"license": "5302029434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bay City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.