Individual provider Active NPI

Elizabeth Ann Woolsey, PHARMD

  • Pharmacist
  • South Bend, IN
National Provider Identifier
1063635993
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26021547A Issued in IN
Practice address
426 N Michigan St
South Bend, IN 46601-1228
Phone
(574) 234-3184
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
26021547AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mar-Main Pharmacy Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26021547A IN Primary

Addresses

NPPES NPI Registry

Primary practice location

426 N Michigan St
South Bend, IN 46601-1228

Mailing address

2200 Hoveland Ave
Long Beach, IN 46360-1521
Phone (219) 879-1640

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063635993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 HOVELAND AVE",
            "city": "LONG BEACH",
            "state": "IN",
            "postal_code": "463601521",
            "telephone_number": "219-879-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 N MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011228",
            "telephone_number": "574-234-3184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLSEY",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26021547A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.