Individual provider Active NPI

Katherine Anne Anthes

  • Pharmacist
  • Grand Rapids, MI
National Provider Identifier
1881978484
Registry record updated Oct 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302032418 Issued in MI
Practice address
6425 28TH St SE
Grand Rapids, MI 49546-6917
Phone
(616) 949-0340
Fax
(616) 949-0903
NPI assigned
Oct 1, 2011
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

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.

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
5302032418MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Prevos Family Markets LLC Past Accepting new patients
Prevos Family Markets LLC PastSince May 21, 2023 Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302032418 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

6425 28TH St SE
Grand Rapids, MI 49546-6917

Mailing address

6425 28TH St SE
Grand Rapids, MI 49546-6917
Phone (616) 949-0340

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 1, 2011.

{
    "created_epoch": "1317427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317427200000",
    "number": "1881978484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6425 28TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466917",
            "telephone_number": "616-949-0340",
            "fax_number": "616-949-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 28TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466917",
            "telephone_number": "616-949-0340",
            "fax_number": "616-949-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTHES",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-01",
        "last_updated": "2011-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302032418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.