Active NPI
Cassandra Sullivan, RPH
- Pharmacist
- Oxford, MS
National Provider Identifier
1144877804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- T-09630
- Practice address
- 502 Woodland Hills Dr
Oxford, MS 38655-9790 - Phone
- (662) 236-1478
- NPI assigned
- Aug 19, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10656 | KY | |
| Pharmacist | 183500000X | T-09630 | MS | Primary |
Addresses
Primary practice location
502 Woodland Hills Dr
Oxford, MS 38655-9790
Mailing address
502 Woodland Hills Dr
Oxford, MS 38655-9790
Phone (662) 236-1478
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T-09630 | Other | MS | MS LICENSE NUMBER |
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 |
|---|---|---|---|
| 10656 | KY | MD | Pharmacist |
| T-09630 | MS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566172800000",
"number": "1144877804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 WOODLAND HILLS DR",
"city": "OXFORD",
"state": "MS",
"postal_code": "386559790",
"telephone_number": "662-236-1478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 WOODLAND HILLS DR",
"city": "OXFORD",
"state": "MS",
"postal_code": "386559790",
"telephone_number": "662-236-1478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "CASSANDRA",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-19",
"last_updated": "2019-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "10656",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "T-09630",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MS LICENSE NUMBER",
"identifier": "T-09630",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oxford, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.