Active NPI
Grace Mwangi
- Pharmacist
- Dorchester, MA
National Provider Identifier
1073117503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH234647
- Practice address
- 715 Morrissey Blvd
Dorchester, MA 02122-3522 - Phone
- (617) 822-1307
- NPI assigned
- Nov 25, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH234647 | MA | Primary |
Addresses
Primary practice location
715 Morrissey Blvd
Dorchester, MA 02122-3522
Mailing address
715 Morrissey Blvd
Dorchester, MA 02122-3522
Phone (508) 826-3789
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH234647 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606262400000",
"number": "1073117503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 MORRISSEY BLVD",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021223522",
"telephone_number": "508-826-3789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 MORRISSEY BLVD",
"city": "DORCHESTER",
"state": "MA",
"postal_code": "021223522",
"telephone_number": "617-822-1307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MWANGI",
"first_name": "GRACE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-25",
"last_updated": "2020-11-25",
"certification_date": "2020-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH234647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dorchester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.