Active NPI
Susan Marie Jacquot
- Pharmacist
- Millbury, MA
National Provider Identifier
1780970129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20210
- Practice address
- 90 Worcester-Providence Turnpike
T1835
Millbury, MA 01527 - Phone
- (508) 865-7454
- Fax
- (508) 865-7454
- NPI assigned
- Jun 23, 2011
- Last updated
- Jun 23, 2011
- 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 | 20210 | MA | Primary |
Addresses
Primary practice location
90 Worcester-Providence Turnpike
T1835
Millbury, MA 01527
Mailing address
12 Henrys Path
Upton, MA 01568-1455
Phone (508) 922-3470
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 |
|---|---|---|---|
| 20210 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308787200000",
"number": "1780970129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 HENRYS PATH",
"city": "UPTON",
"state": "MA",
"postal_code": "015681455",
"telephone_number": "508-922-3470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 WORCESTER-PROVIDENCE TURNPIKE",
"address_2": "T1835",
"city": "MILLBURY",
"state": "MA",
"postal_code": "01527",
"telephone_number": "508-865-7454",
"fax_number": "508-865-7454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACQUOT",
"first_name": "SUSAN",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-23",
"last_updated": "2011-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "20210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Millbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.