Active NPI
Michael T Sorg, R.PH.
- Pharmacist
- Evansville, IN
National Provider Identifier
1386864627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26017706A
- 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
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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 26017706A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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
- Evansville, IN
- NPI 1588861850
-
- Pharmacy
- Longview, TX
- NPI 1629956545
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.