Active NPI
Donald Bradley Massopust
- Pharmacist
- Ashland, WI
National Provider Identifier
1851999320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10793
- Practice address
- 2500 Lake Shore Dr E
Ashland, WI 54806-2421 - Phone
- (715) 682-3660
- Fax
- (715) 685-9941
- NPI assigned
- Oct 15, 2020
- 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 | 10793 | WI | Primary |
Addresses
Primary practice location
2500 Lake Shore Dr E
Ashland, WI 54806-2421
Mailing address
229 E Arch St
Ironwood, MI 49938-2003
Phone (906) 364-2771
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 |
|---|---|---|---|
| 10793 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602720000000",
"number": "1851999320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "229 E ARCH ST",
"city": "IRONWOOD",
"state": "MI",
"postal_code": "499382003",
"telephone_number": "906-364-2771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 LAKE SHORE DR E",
"city": "ASHLAND",
"state": "WI",
"postal_code": "548062421",
"telephone_number": "715-682-3660",
"fax_number": "715-685-9941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASSOPUST",
"first_name": "DONALD",
"middle_name": "BRADLEY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-15",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "10793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ashland, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.