Individual provider Active NPI

John Lauren Somerville, R PH

  • Pharmacist
  • Williamson, NY
National Provider Identifier
1295917623
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
027592 Issued in NY
Practice address
4061 Route 104
Rite Aid # 10856
Williamson, NY 14589-9554
Phone
(315) 589-4691
Fax
(315) 589-4875
NPI assigned
Nov 27, 2007
Last updated
Nov 27, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 027592 NY Primary

Addresses

Primary practice location

4061 Route 104
Rite Aid # 10856
Williamson, NY 14589-9554

Mailing address

4265 Ridge Rd
Williamson, NY 14589-9328
Phone (315) 589-4092

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
027592NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1295917623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4265 RIDGE RD",
            "city": "WILLIAMSON",
            "state": "NY",
            "postal_code": "145899328",
            "telephone_number": "315-589-4092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4061 ROUTE 104",
            "address_2": "RITE AID # 10856",
            "city": "WILLIAMSON",
            "state": "NY",
            "postal_code": "145899554",
            "telephone_number": "315-589-4691",
            "fax_number": "315-589-4875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMERVILLE",
        "first_name": "JOHN",
        "middle_name": "LAUREN",
        "credential": "R PH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-27",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "027592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.