Individual provider Active NPI

Marcyanna Jorae, RPH

  • Pharmacist
  • Dewitt, MI
National Provider Identifier
1851702450
Registry record updated May 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302022907 Issued in MI
Practice address
12821 Cross Over Dr
Dewitt, MI 48820-7993
Phone
(517) 669-4610
NPI assigned
May 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302022907 MI Primary

Addresses

Primary practice location

12821 Cross Over Dr
Dewitt, MI 48820-7993

Mailing address

5122 Alward Rd
Laingsburg, MI 48848-9425
Phone (517) 230-1024

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
5302022907MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400198400000",
    "number": "1851702450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5122 ALWARD RD",
            "city": "LAINGSBURG",
            "state": "MI",
            "postal_code": "488489425",
            "telephone_number": "517-230-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12821 CROSS OVER DR",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488207993",
            "telephone_number": "517-669-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORAE",
        "first_name": "MARCYANNA",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-16",
        "last_updated": "2014-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302022907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dewitt, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.

Verify at the official NPI Registry.