Individual provider Active NPI

Michelle Dawn Myers, PHARM.D.

  • Pharmacist
  • Fort Wayne, IN
National Provider Identifier
1962785048
Registry record updated Sep 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26020550A Issued in IN
Practice address
11932 Lima Rd
Fort Wayne, IN 46818-8658
Phone
(260) 637-6667
NPI assigned
Sep 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26020550A IN Primary

Addresses

Primary practice location

11932 Lima Rd
Fort Wayne, IN 46818-8658

Mailing address

1178 S Old State Road 3
Avilla, IN 46710-9650
Phone (260) 897-2562

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
26020550AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1316822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316822400000",
    "number": "1962785048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1178 S OLD STATE ROAD 3",
            "city": "AVILLA",
            "state": "IN",
            "postal_code": "467109650",
            "telephone_number": "260-897-2562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11932 LIMA RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468188658",
            "telephone_number": "260-637-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "MICHELLE",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-24",
        "last_updated": "2011-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26020550A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.