Individual provider Active NPI

Michele Madere St Pierre, PHARMD

  • Pharmacist
  • Ponchatoula, LA
National Provider Identifier
1861707184
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17416 Issued in LA
Practice address
1100 W Pine St
Ponchatoula, LA 70454-3700
Phone
(985) 902-9249
Fax
(985) 902-9705
NPI assigned
Aug 11, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17416 LA Primary

Addresses

Primary practice location

1100 W Pine St
Ponchatoula, LA 70454-3700

Mailing address

1100 W Pine St
Ponchatoula, LA 70454-3700
Phone (985) 386-2421

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
17416LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Jan 1, 2023 Accepting new patients
Walgreen Louisiana Co Inc Past Accepting new patients
Walgreen Co PastSince Jan 1, 2023 Accepting new patients
Walgreen Louisiana Co, Inc Past Accepting new patients

Locations

1100 W Pine St
Ponchatoula, LA 70454
Phone (985) 386-2421

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1861707184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W PINE ST",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704543700",
            "telephone_number": "985-386-2421",
            "fax_number": "985-386-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W PINE ST",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704543700",
            "telephone_number": "985-902-9249",
            "fax_number": "985-902-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST PIERRE",
        "first_name": "MICHELE",
        "middle_name": "MADERE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2022-12-27",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "17416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponchatoula, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.