Active NPI
Addison James Balzer, PHARMACY INTERN
- Pharmacist
- Grand Rapids, MI
National Provider Identifier
1992466858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5351012502
- Practice address
- 100 Cherry St SE
Grand Rapids, MI 49503-4526 - Phone
- (616) 965-8390
- NPI assigned
- Jan 4, 2022
- Sex
- Male
- 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 | 5351012502 | MI | Primary |
Addresses
Primary practice location
100 Cherry St SE
Grand Rapids, MI 49503-4526
Mailing address
616 4TH St NW Apt 2E
Grand Rapids, MI 49504-5164
Phone (989) 928-5556
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5351012502 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641340800000",
"number": "1992466858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "616 4TH ST NW APT 2E",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495045164",
"telephone_number": "989-928-5556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CHERRY ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495034526",
"telephone_number": "616-965-8390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALZER",
"first_name": "ADDISON",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "PHARMACY INTERN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-04",
"last_updated": "2022-01-05",
"certification_date": "2022-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5351012502",
"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 Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.