Active NPI
Susan C Wilson, RPH
- Pharmacist
- Memphis, TN
National Provider Identifier
1558587352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8340
- Practice address
- 2525 Horizon Lake Dr
Suite 101
Memphis, TN 38133-8119 - Phone
- (901) 248-3700
- NPI assigned
- Apr 18, 2007
- 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 | 8340 | TN | Primary |
Addresses
Primary practice location
2525 Horizon Lake Dr
Suite 101
Memphis, TN 38133-8119
Mailing address
3106 Steeplegate Dr
Germantown, TN 38138-7717
Phone (901) 737-0016
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 |
|---|---|---|---|
| 8340 | TN | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dragonfly Health RX, Inc. | 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 and National Provider Directory roles.
-
- Long Term Care Pharmacy
- Memphis, TN
- NPI 1548371610
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1558587352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3106 STEEPLEGATE DR",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381387717",
"telephone_number": "901-737-0016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 HORIZON LAKE DR",
"address_2": "SUITE 101",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381338119",
"telephone_number": "901-248-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SUSAN",
"middle_name": "C",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "8340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.