Active NPI
Thomas Frank Condon
- Pharmacist
- Livonia, MI
National Provider Identifier
1649878349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302412499
- Practice address
- 17001 Newburgh Rd
Livonia, MI 48154-1610 - Phone
- (734) 462-1707
- NPI assigned
- Oct 14, 2020
- Last updated
- Oct 14, 2020
- Sex
- Male
- 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 | 5302412499 | MI | Primary |
Addresses
Primary practice location
17001 Newburgh Rd
Livonia, MI 48154-1610
Mailing address
17920 Brentwood Dr
Riverview, MI 48193-8153
Phone (734) 626-9034
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5302412499 | Other | MI | LARA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | n/a | Direct |
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 |
|---|---|---|---|
| 5302412499 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
17001 Newburgh Rd
Livonia, MI 48154
Phone (734) 462-1707
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": "1602633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602633600000",
"number": "1649878349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17920 BRENTWOOD DR",
"city": "RIVERVIEW",
"state": "MI",
"postal_code": "481938153",
"telephone_number": "734-626-9034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17001 NEWBURGH RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481541610",
"telephone_number": "734-462-1707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONDON",
"first_name": "THOMAS",
"middle_name": "FRANK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-14",
"last_updated": "2020-10-14",
"certification_date": "2020-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302412499",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LARA",
"identifier": "5302412499",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "n/a",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "17001 Newburgh Rd",
"city": "Livonia",
"state": "MI",
"country_code": "US",
"postal_code": "481541610",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.