Individual provider Active NPI

Nancy Jean Vantill, RPH

  • Pharmacist
  • Caledonia, MI
National Provider Identifier
1851677801
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302029692 Issued in MI
Practice address
9375 Cherry Valley Ave SE
Caledonia, MI 49316-9506
Phone
(616) 698-1964
NPI assigned
Oct 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 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 5302029692 MI Primary

Addresses

Primary practice location

9375 Cherry Valley Ave SE
Caledonia, MI 49316-9506

Mailing address

9375 Cherry Valley Ave SE
Caledonia, MI 49316-9506
Phone (616) 698-1964

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

LicenseStateTypeSpecialty
5302029692MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1851677801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9375 CHERRY VALLEY AVE SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493169506",
            "telephone_number": "616-698-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9375 CHERRY VALLEY AVE SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493169506",
            "telephone_number": "616-698-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANTILL",
        "first_name": "NANCY",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-21",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302029692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caledonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.