DR. MICHAEL MICELLI (NPI# 1043682735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043682735 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL MICELLI |
| Credential | RPH. |
| Practice Address |
182 Nc 102 East Ayden NC 28513 |
| Practice Telephone | 2527462699 |
| Practice Fax Number | 2527463164 |
| Mailing Telephone | 2527462699 |
| Mailing Fax Number | 2527463164 |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2015-10-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 24333 | NC | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | STATE LICENSE NUMBER | 24333 | 01 |
| Street Address |
182 NC 102 EAST |
| City | AYDEN |
| State | NC |
| Zip Code | 28513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871075424 | Mariah Vanstaalduinen | Occupational Therapist | 128 Snowhill Rd, Ayden, NC 28513 | 2018-08-30 |
| 1356679302 | Leigh Ann Teal | Pharmacist | 140 Nc Hwy 102 East, Ayden, NC 28513 | 2009-12-03 |
| 1932370699 | Richard Frazier | Family Medicine | 182 Gumberry Rd, Ayden, NC 28513 | 2008-03-20 |
| 1376712836 | Ronald D Bancroft | Counselor | 417 A First Street, Ayden, NC 28513 | 2008-02-28 |
| 1104040815 | Edith L Smith | Occupational Therapist | 642 E 2nd Street, Ayden, NC 28513 | 2007-04-12 |
| 1376653071 | Kerr Drug Inc | Pharmacy | 140 Nc Hwy 102 West, Ayden, NC 28513 | 2006-08-30 |
| 1548221039 | Tracey Walston Bowen | Internal Medicine | 137 Third Street, Ayden, NC 28513 | 2006-04-01 |
| 1760703631 | Richard Garrett Roach | Pharmacist | 140 Nc Hwy 102 West, Kerr Drug #500, Ayden, NC 28513 | 2010-06-15 |
| 1346458916 | Stephen Chambers | Social Worker | 175 Philpot Lane, Beaver, WV 28513 | 2007-05-18 |
| 1205898426 | James Madison Galloway Jr. | Family Medicine | 137 Third Street, Ayden, NC 28513 | 2006-04-04 |
| Find all providers in zip 28513 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154604270 | Mitesh S Patel | Pharmacist | 131 Third St, Ayden, NC 28513-7252 | 2011-09-25 |
| 1356679302 | Leigh Ann Teal | Pharmacist | 140 Nc Hwy 102 East, Ayden, NC 28513 | 2009-12-03 |
| 1194292003 | Connor Bradley Alcide | Pharmacist | 140 Nc 102 W, Ayden, NC 28513-8792 | 2018-10-29 |
| 1477038198 | Crista Hughes | Pharmacist | 140 Nc 102 W, Ayden, NC 28513-8792 | 2018-09-27 |
| 1730591496 | Stephen Hodgson | Pharmacist | 182 Nc 102 W, Ayden, NC 28513-8792 | 2014-05-28 |
| 1669724449 | Robert Horace Tripp | Pharmacist | 131 Third Street, Ayden, NC 28513-7252 | 2012-10-04 |
| 1164711065 | William Keith Holley | Pharmacist | 140 Nc 102 W, Ayden, NC 28513-8792 | 2011-03-31 |
| 1760703631 | Richard Garrett Roach | Pharmacist | 140 Nc Hwy 102 West, Kerr Drug #500, Ayden, NC 28513 | 2010-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720688401 | Melissa Claire Kratz | Pharmacist | 930 Hwy 711 East, Pembroke, NC 28372 | 2020-10-30 |
| 1679173611 | Keith Mcbrayer Hunt | Pharmacist | 630 Bostic Sunshine Hwy, Bostic, NC 28018-9779 | 2020-10-29 |
| 1518566066 | Amitkumar Prahaladbhai Patel | Pharmacist | 5450 New Hope Commons Dr # 2137, Durham, NC 27707-9716 | 2020-10-25 |
| 1619576568 | Efthalia Retsios Rodriguez | Pharmacist | 7860 Rea Rd # 16466, Charlotte, NC 28277-6502 | 2020-10-21 |
| 1578160149 | Brett Daniel England | Pharmacist | 401 Glenwood Ave Ste 101, Raleigh, NC 27603-1219 | 2020-10-06 |
| 1215544580 | Sarah Payne Maddox | Pharmacist | 1 Hospital Dr Rm 2231, Asheville, NC 28801-4550 | 2020-09-30 |
| 1093321739 | James Doyle Richardson | Pharmacist | 1072 N Main St Ste 103, Walnut Cove, NC 27052-9312 | 2020-09-18 |
| 1922614643 | Sharisse Berry | Pharmacist | 425 Sawyers Mill Rd Apt 306, Charlotte, NC 28262-1877 | 2020-09-17 |
| 1912512997 | Sheri Mitten | Pharmacist | 202 Swordgate Dr, Cary, NC 27513-1630 | 2020-09-15 |
| 1669087953 | Elton Wayne Long | Pharmacist | 5106 Nc Highway 87 S Ste 100, Fayetteville, NC 28306-3424 | 2020-09-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.