DR. RYAN ROBERT KITTREDGE (NPI# 1992341101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992341101 |
| Entity Type | Individual |
| Full Name | DR. RYAN ROBERT KITTREDGE |
| Practice Address |
20891 E 13 Mile Rd Roseville MI 48066-4530 |
| Practice Telephone | 5862983855 |
| Practice Fax Number | 5862983857 |
| Mailing Telephone | 5862983855 |
| Mailing Fax Number | 5862983857 |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2019-12-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 5302039476 | MI | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
5302039476 | MI | Pharmacy Service Providers |
| Street Address |
20891 E 13 MILE RD |
| City | ROSEVILLE |
| State | MI |
| Zip Code | 48066-4530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013386986 | Kroger Co of Michigan | Durable Medical Equipment & Medical Supplies | 20891 E 13 Mile Rd, Roseville, MI 48066-4530 | 2015-09-21 |
| 1760094619 | Vmlp Rose Pllc | Dentist | 20891 E 13 Mile Rd, Roseville, MI 48066-4530 | 2020-08-21 |
| 1336785658 | Sandy Lotfy Samy-tawdrous | Pharmacist | 20891 E 13 Mile Rd, Roseville, MI 48066-4530 | 2019-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761400 | Louay Mansour Dds PC | Dentist | 27845 Gratiot Avenue, Roseville, MI 48066 | 2020-08-20 |
| 1558911842 | Jomy Jose | Nurse Practitioner | 25719 Salem St, Roseville, MI 48066 | 2019-09-18 |
| 1053963033 | Convenient Rv PC | Dentist | 19551 E. 10 Mile Rd, Roseville, MI 48066 | 2019-07-10 |
| 1063914539 | Colleen Meriweather | Registered Nurse | 27300 Spruce, Rosevilel, MI 48066 | 2018-03-01 |
| 1326565789 | Renee Suzette Hoelzeman | Nurse Practitioner | 18472 Meier St, Roseville, MI 48066 | 2017-08-27 |
| 1225561400 | Eugenia Dillard | Counselor | 28351 Gratiot Ave., Suite 3, Roseville, MI 48066 | 2017-04-05 |
| 1932651338 | Julie Plichota | Physical Therapist | 31120 Gratiot Ave, Roseville, MI 48066 | 2016-11-01 |
| 1699221325 | Jaquenta Glasker | Technician, Other | 26778 Rosewood, Roseville, MI 48066 | 2016-09-01 |
| 1609296144 | Peter Jajou | Dermatology | 18285 E 10 Mile Rd Ste 130, Roseville, MI 48066 | 2014-04-23 |
| 1619393899 | Katherine Michelle Johnson | Obstetrics & Gynecology | 29751 Little Mack Ave Ste B, Roseville, MI 48066 | 2014-03-11 |
| Find all providers in zip 48066 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235601733 | Mihyang Song | Pharmacist | 4001 Impala Cir, Roseville, CA 95678-6744 | 2018-12-20 |
| 1467617720 | Cathy Marie Spencer | Pharmacist | 1752 Terrace Dr, Roseville, MN 55113-1315 | 2008-07-25 |
| 1164069936 | Paul Donald Schroff | Pharmacist | 30851 Gratiot Ave, Roseville, MI 48066-1769 | 2019-11-29 |
| 1346886132 | Roy Toubassi | Pharmacist | 30851 Gratiot Ave, Roseville, MI 48066-1769 | 2019-11-27 |
| 1700422086 | Asobari Amachree | Pharmacist | 26130 Gratiot Ave, Roseville, MI 48066-5111 | 2019-11-21 |
| 1336785658 | Sandy Lotfy Samy-tawdrous | Pharmacist | 20891 E 13 Mile Rd, Roseville, MI 48066-4530 | 2019-11-21 |
| 1568008928 | Jimmy Tran | Pharmacist | 26130 Gratiot Ave, Roseville, MI 48066-5111 | 2019-11-20 |
| 1669980181 | Sukhjeet Singh Hundal | Pharmacist | 1600 Eureka Rd, Roseville, CA 95661-3027 | 2018-01-18 |
| 1134446867 | Melanie Anne Haggard | Pharmacist | 1600 Eureka Rd, Inpatient Pharmacy Administration, Roseville, CA 95661-3027 | 2010-04-20 |
| 1114169497 | Nam Nguyen | Pharmacist | 1600 Eureka Rd, Roseville, CA 95661-3027 | 2009-04-01 |
| Find all providers in ROSEVILLE | ||||
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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.