Michael Trent Macon, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

15613 Issued in OK

Practice address

102 Waldron Dr
Durant, OK 74701-1902

Phone

(580) 920-2211

NPI assigned

Nov 20, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Pharmcareok of Durant Inc

  • Long Term Care Pharmacy
  • Durant, OK
  • NPI 1356370076
  NPD (past)
• Pharmcareok of Durant, Inc.

  • Community/Retail Pharmacy
  • Durant, OK
  • NPI 1487088175
  NPD (past)

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1972106979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 BANDERA DR",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750924525",
            "telephone_number": "903-328-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WALDRON DR",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747011902",
            "telephone_number": "580-920-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACON",
        "first_name": "MICHAEL",
        "middle_name": "TRENT",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "57862",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "15613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Magnolia Smiles
• Marquin Lynn Malone
• Hailey Cheyenne Manners

• Pharmacist in Durant, OK
• Providers in Durant, OK by specialty
• Pharmacist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.

Verify at the official NPI Registry.