NPIMap

Individual provider Active NPI

Robert M Gladstone, RPH

  • Pharmacist
  • Lawrence, MA
National Provider Identifier
1093923898
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16258 Issued in MA
Practice address
150 Park St
Lawrence, MA 01841-2517
Phone
(978) 686-4453
NPI assigned
May 18, 2007
Last updated
Feb 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16258 MA Primary
Pharmacist 183500000X R1023 NH
Pharmacist 183500000X 6043 CT

Addresses

Primary practice location

150 Park St
Lawrence, MA 01841-2517

Mailing address

150 Park St
Lawrence, MA 01841-2517
Phone (978) 686-4453

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
6043CTMDPharmacist
R1023NHMDPharmacist
16258MAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1093923898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PARK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412517",
            "telephone_number": "978-686-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PARK ST",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412517",
            "telephone_number": "978-686-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADSTONE",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "16258",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NH",
            "license": "R1023",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "6043",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.