Individual provider Active NPI

Shaneequa Bennett, PHARMD

  • Pharmacist
  • Westborough, MA
National Provider Identifier
1790501807
Registry record updated Nov 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH997102 Issued in MA
Practice address
74 E Main St
Westborough, MA 01581-1416
Phone
(508) 366-0670
NPI assigned
Nov 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH997102 MA Primary

Addresses

Primary practice location

74 E Main St
Westborough, MA 01581-1416

Mailing address

165A Orient St
Worcester, MA 01604-2945

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

LicenseStateTypeSpecialty
PH997102MAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732320000000",
    "number": "1790501807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165A ORIENT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016042945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 E MAIN ST",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015811416",
            "telephone_number": "508-366-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "SHANEEQUA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-23",
        "last_updated": "2024-11-23",
        "certification_date": "2024-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH997102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.