Active NPI
Cynthia Dorety
- Pharmacist
- Massillon, OH
National Provider Identifier
1114523404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03117657
- 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
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 | 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 03117657 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohio CVS Stores LLC | Past | Accepting new patients | |
| Ohio CVS Stores, L.L.C. | 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.
-
- Pharmacy
- Massillon, OH
- NPI 1477844926
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- Pharmacy
- Woodmere, OH
- NPI 1922736305
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.