Active NPI
Lynn M Goris, RPH
- Pharmacist
- Rockledge, FL
National Provider Identifier
1114054848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS37487
- Practice address
- 1770 Cedar St
Rockledge, FL 32955-3133 - Phone
- (321) 890-1590
- NPI assigned
- Feb 28, 2007
- 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 | PS37487 | FL | Primary |
Addresses
Primary practice location
1770 Cedar St
Rockledge, FL 32955-3133
Mailing address
1770 Cedar St
Rockledge, FL 32955-3133
Phone (321) 890-1590
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106351100 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS37487 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1114054848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1770 CEDAR ST",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329553133",
"telephone_number": "321-890-1590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1770 CEDAR ST",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329553133",
"telephone_number": "321-890-1590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORIS",
"first_name": "LYNN",
"middle_name": "M",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS37487",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106351100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockledge, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.