Individual provider Active NPI

Marilyn Diane Ingland, PHARM D.

  • Pharmacist
  • Howell, MI
National Provider Identifier
1811265473
Registry record updated Dec 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302410151 Issued in MI
Practice address
108 W Highland Rd
Howell, MI 48843-1159
Phone
(517) 552-0205
NPI assigned
Dec 9, 2011
Last updated
Dec 9, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302410151 MI Primary

Addresses

Primary practice location

108 W Highland Rd
Howell, MI 48843-1159

Mailing address

4494 Grape Vine Dr
Howell, MI 48843-7295
Phone (517) 546-0573

Other identifiers 1

IdentifierTypeStateIssuer
5302410151OtherMILICENSE NUMBER FOR THE STATE OF MICHIGAN

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302410151MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Co of Michigan Past Accepting new patients
Kroger Co of Michigan Past Accepting new patients

Organizations & group practices 2

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": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323388800000",
    "number": "1811265473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4494 GRAPE VINE DR",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488437295",
            "telephone_number": "517-546-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W HIGHLAND RD",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488431159",
            "telephone_number": "517-552-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGLAND",
        "first_name": "MARILYN",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "PHARM D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-09",
        "last_updated": "2011-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302410151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER FOR THE STATE OF MICHIGAN",
            "identifier": "5302410151",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Howell, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; 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.