Active NPI
Melissa Dorismond, PHARMD
- Pharmacist
- Lynn, MA
National Provider Identifier
1407468291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH239186
- Practice address
- 290 Broadway
Lynn, MA 01904-1806 - Phone
- (781) 581-9400
- NPI assigned
- Aug 21, 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 | PH239186 | MA | Primary |
Addresses
Primary practice location
290 Broadway
Lynn, MA 01904-1806
Mailing address
290 Broadway
Lynn, MA 01904-1806
Phone (781) 581-9400
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH239186 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co Inc | Past | Accepting new patients | |
| Walgreen Eastern Co 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": "1597968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597968000000",
"number": "1407468291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 BROADWAY",
"city": "LYNN",
"state": "MA",
"postal_code": "019041806",
"telephone_number": "781-581-9400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 BROADWAY",
"city": "LYNN",
"state": "MA",
"postal_code": "019041806",
"telephone_number": "781-581-9400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORISMOND",
"first_name": "MELISSA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-21",
"last_updated": "2020-08-21",
"certification_date": "2020-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH239186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.