Individual provider Active NPI

Stephen A Baranec, RPH

  • Pharmacist
  • Marquette, MI
National Provider Identifier
1972992402
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302020550 Issued in MI
Practice address
3250 US Highway 41 W
Marquette, MI 49855-9483
Phone
(906) 226-0095
NPI assigned
Jan 21, 2015
Sex
Male
Sole proprietor
No

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302020550MIMDPharmacist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302020550 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

3250 US Highway 41 W
Marquette, MI 49855-9483

Mailing address

1753 E Front St
Traverse City, MI 49686-6014
Phone (231) 943-1714

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
9999999MedicaidMI
99999999MedicaidMI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 21, 2015.

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1972992402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1753 E FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496866014",
            "telephone_number": "231-943-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 US HIGHWAY 41 W",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498559483",
            "telephone_number": "906-226-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARANEC",
        "first_name": "STEPHEN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-21",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302020550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9999999",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99999999",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.