Active NPI
Susan Beth Henderson, BS PHARMACY RPH
- Pharmacist
- Muskegon, MI
National Provider Identifier
1477834935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302027794
- Practice address
- 1991 E Apple Ave
Muskegon, MI 49442-4246 - Phone
- (231) 773-1540
- NPI assigned
- Aug 29, 2011
- Last updated
- Aug 29, 2011
- 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 | 5302027794 | MI | Primary |
Addresses
Primary practice location
1991 E Apple Ave
Muskegon, MI 49442-4246
Mailing address
15844 Cotters Dr
Spring Lake, MI 49456-1582
Phone (616) 847-2928
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
- Bachelor of Science, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302027794 | MI | 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, 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": "1314576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314576000000",
"number": "1477834935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15844 COTTERS DR",
"city": "SPRING LAKE",
"state": "MI",
"postal_code": "494561582",
"telephone_number": "616-847-2928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1991 E APPLE AVE",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494424246",
"telephone_number": "231-773-1540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDERSON",
"first_name": "SUSAN",
"middle_name": "BETH",
"credential": "BS PHARMACY RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-29",
"last_updated": "2011-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302027794",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.