Active NPI
Susan Willis, PHARM D
- Pharmacist
- Mooreville, MS
National Provider Identifier
1669956553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E-08637
- Practice address
- 712 Highway 371
Mooreville, MS 38857-7356 - Phone
- (662) 840-5601
- NPI assigned
- Sep 18, 2018
- 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 | E-08637 | MS | Primary |
Addresses
Primary practice location
712 Highway 371
Mooreville, MS 38857-7356
Mailing address
146 Drive 1375
Mooreville, MS 38857-7209
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-08637 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sonshine Pharmacy, LLC | Current | Accepting new patients |
Locations
712 Highway 371
Mooreville, MS 38857
Phone (662) 840-5601
Interoperability endpoints
- smwillis71@sonshinepharmacy.libertysoftwaredirect.com
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.
-
- Community/Retail Pharmacy
- Mooreville, MS
- NPI 1881162857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582588800000",
"number": "1669956553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "146 DRIVE 1375",
"city": "MOOREVILLE",
"state": "MS",
"postal_code": "388577209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 HIGHWAY 371",
"city": "MOOREVILLE",
"state": "MS",
"postal_code": "388577356",
"telephone_number": "662-840-5601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "SUSAN",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-18",
"last_updated": "2020-02-25",
"certification_date": "2020-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-08637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mooreville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.