Active NPI
Marissa Derouen
- Pharmacist
- West Bridgewater, MA
National Provider Identifier
1407451016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 239755
- Practice address
- 2 W Center St
West Bridgewater, MA 02379-1741 - Phone
- (508) 588-8050
- NPI assigned
- Dec 1, 2020
- Last updated
- Dec 1, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 239755 | MA | Primary |
Addresses
Primary practice location
2 W Center St
West Bridgewater, MA 02379-1741
Mailing address
2 W Center St
West Bridgewater, MA 02379-1741
Phone (508) 588-8050
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 239755 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Pharmacy Inc | Past | Accepting new patients | |
| CVS Pharmacy Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606780800000",
"number": "1407451016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 W CENTER ST",
"city": "WEST BRIDGEWATER",
"state": "MA",
"postal_code": "023791741",
"telephone_number": "508-588-8050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 W CENTER ST",
"city": "WEST BRIDGEWATER",
"state": "MA",
"postal_code": "023791741",
"telephone_number": "508-588-8050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEROUEN",
"first_name": "MARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-01",
"last_updated": "2020-12-01",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "239755",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Bridgewater, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.