Active NPI
Thomas Keogh, R.PH.
- Pharmacist
- Mansfield, MA
National Provider Identifier
1720112048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16577
- Practice address
- 377 Chauncy St
Mansfield, MA 02048-1169 - Phone
- (508) 337-9455
- Fax
- (508) 337-9464
- NPI assigned
- Mar 16, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 | 16577 | MA | Primary |
Addresses
Primary practice location
377 Chauncy St
Mansfield, MA 02048-1169
Mailing address
9 Wicklow LN
Mansfield, MA 02048-3436
Phone (508) 337-6054
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 |
|---|---|---|---|
| 16577 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Stop & Shop Supermarket Company LLC | Past | Accepting new patients | |
| Stop and Shop Supermarket Co LLC | 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.
-
dba Stop and Shop Pharmacy 7
- Community/Retail Pharmacy
- Mansfield, MA
- NPI 1770515652
-
dba Stop & Shop Pharmacy 2818
- Community/Retail Pharmacy
- Kinnelon, NJ
- NPI 1932570363
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720112048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 WICKLOW LN",
"city": "MANSFIELD",
"state": "MA",
"postal_code": "020483436",
"telephone_number": "508-337-6054",
"fax_number": "508-337-9464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "377 CHAUNCY ST",
"city": "MANSFIELD",
"state": "MA",
"postal_code": "020481169",
"telephone_number": "508-337-9455",
"fax_number": "508-337-9464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEOGH",
"first_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "16577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, MA
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.