Individual provider Active NPI

Michael T Sorg, R.PH.

  • Pharmacist
  • Evansville, IN
National Provider Identifier
1386864627
Registry record updated Dec 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26017706A Issued in IN
Practice address
4828 Davis Lant Dr
Evansville, IN 47715-8919
Phone
(812) 475-9541
Fax
(812) 475-9636
NPI assigned
Apr 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 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 26017706A IN Primary

Addresses

Primary practice location

4828 Davis Lant Dr
Evansville, IN 47715-8919

Mailing address

1529 E 1200 S
Haubstadt, IN 47639-7932
Phone (812) 453-7478

Other practice location 1

925 S Green River Rd
Evansville, IN 47715-4107
Phone (812) 474-0055

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
26017706AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Jan 3, 2021 Accepting new patients
Walgreen Co PastSince Jan 3, 2021 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": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608940800000",
    "number": "1386864627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 E 1200 S",
            "city": "HAUBSTADT",
            "state": "IN",
            "postal_code": "476397932",
            "telephone_number": "812-453-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4828 DAVIS LANT DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477158919",
            "telephone_number": "812-475-9541",
            "fax_number": "812-475-9636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 S Green River Rd",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477154107",
            "country_code": "US",
            "telephone_number": "812-474-0055",
            "fax_number": "812-474-0982",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SORG",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-27",
        "last_updated": "2020-12-26",
        "certification_date": "2020-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26017706A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.