Active NPI
Michelle Marie Proskovec, PHARMD
- Pharmacist
- Cedar Rapids, IA
National Provider Identifier
1902437668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19327
- Practice address
- 4825 Johnson Ave NW
Cedar Rapids, IA 52405-4207 - Phone
- (319) 396-7419
- Fax
- (319) 396-5916
- NPI assigned
- Jan 31, 2020
- Sex
- Female
- 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 | 19327 | IA | Primary |
Addresses
Primary practice location
4825 Johnson Ave NW
Cedar Rapids, IA 52405-4207
Mailing address
3410 Ushers Ridge Blvd NE
Cedar Rapids, IA 52411-2202
Phone (319) 310-1008
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19327 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580428800000",
"number": "1902437668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3410 USHERS RIDGE BLVD NE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524112202",
"telephone_number": "319-310-1008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4825 JOHNSON AVE NW",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524054207",
"telephone_number": "319-396-7419",
"fax_number": "319-396-5916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROSKOVEC",
"first_name": "MICHELLE",
"middle_name": "MARIE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-31",
"last_updated": "2020-01-31",
"certification_date": "2020-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "19327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.