Kroger Co of Michigan
NPI 1467486217 · Community/Retail Pharmacy · South Lyon, MI
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kroger Co of Michigan is a Community/Retail Pharmacy organization in South Lyon, MI (NPI 1467486217).
Provider details
- NPI number
- 1467486217
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Jessie Warman, Manager Rx Licensing(513) 762-1090
Specialties & taxonomies
Suppliers
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
19 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
361 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Administration of Influenza Virus VaccineG0008 | 185 | $12 |
| Admn Sarscov2 Vacc 1 Dose90480 | 163 | $29 |
| Administration of Pneumococcal VaccineG0009 | 13 | $17 |
Typical Medicare-allowed amounts for these services range $12–$29 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Kroger Pharmacy
- Doing business as
- Kroger Pharmacy
Registry dates
- Enumerated
- 2006-07-10
- Last updated
- 2019-01-16
Frequently asked questions
- What is Kroger Co of Michigan's NPI number?
- Kroger Co of Michigan's National Provider Identifier (NPI) is 1467486217, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kroger Co of Michigan?
- Kroger Co of Michigan is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Kroger Co of Michigan located?
- Kroger Co of Michigan's practice location on file with NPPES is 20730 Pontiac Trl, South Lyon, MI 48178-9486.
- What is Kroger Co of Michigan's phone number?
- The practice phone number listed in the NPPES registry for Kroger Co of Michigan is (248) 486-9182.
- Does Kroger Co of Michigan accept Medicare?
- Kroger Co of Michigan is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Kroger Co of Michigan?
- The authorized official listed on Kroger Co of Michigan's NPPES record is Jessie Warman, Manager Rx Licensing. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kroger Co of Michigan's NPI active?
- Yes — Kroger Co of Michigan's NPI (1467486217) is active in the NPPES registry as of the last update on 2019-01-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.