Todd Super, PHARM.D., BCPS

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

5302036387 Issued in MI

Practice address

451 Health Pkwy
Paw Paw, MI 49079

Phone

(269) 655-1735

NPI assigned

Jul 31, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1053729269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 HEALTH PKWY STE F",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490798242",
            "telephone_number": "269-655-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 HEALTH PKWY",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "49079",
            "telephone_number": "269-655-1735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 North Ave",
            "address_purpose": "LOCATION",
            "city": "Battle Creek",
            "state": "MI",
            "postal_code": "490173307",
            "country_code": "US",
            "telephone_number": "126-924-5852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUPER",
        "first_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "PHARM.D., BCPS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302036387",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MI",
            "license": "5302036387",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "MI",
            "license": "5302036387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tonya Reneae Stevens
• Bryce Anthony Stokes
• Julie Ann Strong, L.L.P., C.A.A.D.C.
• Kayla Stull, RBT
• Lindsay Diane Stull, LLP
• Caitlyn Suski, PHARM.D.
• Guadalupe Sustaita
• Heidi Lucas Sward, FNP-C
• Scott Talmage
• Joyce Evalynne Tamer, M.A., L.P.C.

• Ambulatory Care Pharmacist in Paw Paw, MI
• Providers in Paw Paw, MI by specialty
• Ambulatory Care Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.