Susan Helen Levesque-Degrazia, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

3019 Issued in RI

Practice address

400 Metacom Ave
Bristol, RI 02809-5188

Phone

(401) 253-2050

Fax

(401) 254-7413

NPI assigned

Nov 30, 2020

Last updated

Nov 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rhode Island CVS Pharmacy LLC

  dba CVS Pharmacy # 04544

  • Pharmacy
  • North Kingstown, RI
  • NPI 1063037059
  NPD (past)
• Rhode Island CVS Pharmacy, L.L.C.

  dba CVS Pharmacy # 00645

  • Pharmacy
  • Bristol, RI
  • NPI 1407950207
  NPD (past)

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1396340378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 METACOM AVE",
            "city": "BRISTOL",
            "state": "RI",
            "postal_code": "028095188",
            "telephone_number": "401-253-2050",
            "fax_number": "401-254-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 METACOM AVE",
            "city": "BRISTOL",
            "state": "RI",
            "postal_code": "028095188",
            "telephone_number": "401-253-2050",
            "fax_number": "401-254-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVESQUE-DEGRAZIA",
        "first_name": "SUSAN",
        "middle_name": "HELEN",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "19353",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "RI",
            "license": "3019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CVS PHARMACY 645",
            "identifier": "1407950207",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Direct",
            "affiliation": "N",
            "endpointDescription": "CVS Pharmacy 645",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "400 Metacom Ave",
            "city": "Bristol",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028095188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paul M Kotuby Jr., D.M.D.
• James C. Kovolyan II, PT
• John Labao
• Sarah Elizabeth Flinn Larson, MS, RD, LDN
• Lepre Physical Therapy of Bristol, LLC
• Sulwa Lima
• Kelly A. Lively, P.T.
• Living in Fulfilling Environments, Inc.
• Living in Fulfilling Environments, Inc.
• Living in Fulfilling Environments, Inc.

• Pharmacist in Bristol, RI
• Providers in Bristol, RI by specialty
• Pharmacist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.