Active NPI
Susan Gordon
- Pharmacist
- Sarasota, FL
National Provider Identifier
1477158145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS34146
- Practice address
- 2773 Fruitville Rd
Sarasota, FL 34237-5224 - Phone
- (941) 365-1464
- NPI assigned
- 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 | PS34146 | FL | Primary |
Addresses
Primary practice location
2773 Fruitville Rd
Sarasota, FL 34237-5224
Mailing address
2773 Fruitville Rd
Sarasota, FL 34237-5224
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | RX00312@CVSHealth.com |
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 |
|---|---|---|---|
| PS34146 | FL | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Past | Accepting new patients | |
| Holiday CVS L.L.C. | 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.
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": "1477158145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2773 FRUITVILLE RD",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342375224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2773 FRUITVILLE RD",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342375224",
"telephone_number": "941-365-1464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "SUSAN",
"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": "FL",
"license": "PS34146",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "RX00312@CVSHealth.com",
"affiliation": "N",
"address_1": "2773 Fruitville Rd",
"city": "Sarasota",
"state": "FL",
"country_code": "US",
"postal_code": "342375224",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Sarasota, FL
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.