Active NPI
David Joseph Realy
- Pharmacist
- Flint, MI
National Provider Identifier
1871156646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302027489
- Practice address
- 2900 N Saginaw St
Flint, MI 48505-4452 - Phone
- (810) 789-9141
- NPI assigned
- Apr 17, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302027489 | MI | Primary |
Addresses
Primary practice location
2900 N Saginaw St
Flint, MI 48505-4452
Mailing address
225 E 5TH St Ste 300
Flint, MI 48502-1641
Phone (810) 406-4941
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5302027489 | Other | MI | STATE LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302027489 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555459200000",
"number": "1871156646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 E 5TH ST STE 300",
"city": "FLINT",
"state": "MI",
"postal_code": "485021641",
"telephone_number": "810-406-4941",
"fax_number": "810-234-7068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 N SAGINAW ST",
"city": "FLINT",
"state": "MI",
"postal_code": "485054452",
"telephone_number": "810-789-9141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REALY",
"first_name": "DAVID",
"middle_name": "JOSEPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-17",
"last_updated": "2019-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302027489",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "5302027489",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.