Individual provider Active NPI

Lynneise Karadsheh

  • Pharmacist
  • South Haven, MI
National Provider Identifier
1821702135
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5351016324 Issued in MI
Practice address
201 73Rd St
South Haven, MI 49090-7907
Phone
(269) 639-2260
NPI assigned
Jan 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5351016324 MI Primary

Addresses

Primary practice location

201 73Rd St
South Haven, MI 49090-7907

Mailing address

201 73Rd St
South Haven, MI 49090-7907

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
5351016324MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1821702135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 73RD ST",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490907907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 73RD ST",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490907907",
            "telephone_number": "269-639-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARADSHEH",
        "first_name": "LYNNEISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5351016324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; 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.