Individual provider Active NPI

Cynthia Dorety

  • Pharmacist
  • Massillon, OH
National Provider Identifier
1114523404
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03117657 Issued in OH
Practice address
1130 Lincoln Way E
Massillon, OH 44646-6951
Phone
(330) 830-6459
NPI assigned
Dec 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03117657 OH Primary

Addresses

Primary practice location

1130 Lincoln Way E
Massillon, OH 44646-6951

Mailing address

9163 Brookledge Ave NW
North Canton, OH 44720-9829
Phone (330) 618-1803

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL CVS

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

LicenseStateTypeSpecialty
03117657OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio CVS Stores LLC PastSince Dec 13, 2020 Accepting new patients
Ohio CVS Stores, L.L.C. PastSince Dec 13, 2020 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": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1114523404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9163 BROOKLEDGE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447209829",
            "telephone_number": "330-618-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446466951",
            "telephone_number": "330-830-6459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORETY",
        "first_name": "CYNTHIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03117657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CVS",
            "affiliation": "N",
            "address_1": "1130 Lincoln Way E",
            "city": "Massillon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "446466951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

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

Verify at the official NPI Registry.