Active NPI
Susan Bernal, RPH
- Pharmacist
- Grand Rapids, MI
National Provider Identifier
1487285250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302032132
- Practice address
- 727 28TH St SE
Grand Rapids, MI 49548-1303 - Phone
- (616) 514-5602
- NPI assigned
- Jan 30, 2020
- Last updated
- Jan 30, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 5302032132 | MI | Primary |
Addresses
Primary practice location
727 28TH St SE
Grand Rapids, MI 49548-1303
Mailing address
727 28TH St SE
Grand Rapids, MI 49548-1303
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302032132 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodward Detroit CVS LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1580342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580342400000",
"number": "1487285250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "727 28TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495481303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "727 28TH ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495481303",
"telephone_number": "616-514-5602"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNAL",
"first_name": "SUSAN",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-30",
"last_updated": "2020-01-30",
"certification_date": "2020-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302032132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.