NPIMap

Individual provider Active NPI

Denise Jacques Svoboda, RPH

  • Pharmacist
  • Middletown, CT
National Provider Identifier
1801162946
Registry record updated Mar 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0007568 Issued in CT
Practice address
416 E Main St
Middletown, CT 06457-4555
Phone
(860) 346-1779
NPI assigned
Mar 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT.0007568 CT Primary

Addresses

Primary practice location

416 E Main St
Middletown, CT 06457-4555

Mailing address

416 E Main St
Middletown, CT 06457-4555
Phone (860) 346-1779

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

LicenseStateTypeSpecialty
PCT.0007568CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Stop and Shop Supermarket Co 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332374400000",
    "number": "1801162946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574555",
            "telephone_number": "860-346-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574555",
            "telephone_number": "860-346-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SVOBODA",
        "first_name": "DENISE",
        "middle_name": "JACQUES",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2012-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0007568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; 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.