Active NPI
Susan Lee Isaacs, D.PH.
- Pharmacist
- Edmond, OK
National Provider Identifier
1912066770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11706
- Practice address
- 120 N Bryant Ave
Edmond, OK 73034-6302 - Phone
- (405) 341-8490
- Fax
- (405) 341-8496
- NPI assigned
- Dec 7, 2006
- Last updated
- Apr 27, 2020
- 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 | 11706 | OK | Primary |
Addresses
Primary practice location
120 N Bryant Ave
Edmond, OK 73034-6302
Mailing address
6941 W Simmons Rd
Edmond, OK 73003-1705
Phone (405) 348-6497
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 |
|---|---|---|---|
| 11706 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinic Pharmacy Inc | Current | Accepting new patients |
Locations
120 N Bryant Ave
Edmond, OK 73034
Phone (405) 210-7234
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587945600000",
"number": "1912066770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6941 W SIMMONS RD",
"city": "EDMOND",
"state": "OK",
"postal_code": "730031705",
"telephone_number": "405-348-6497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 N BRYANT AVE",
"city": "EDMOND",
"state": "OK",
"postal_code": "730346302",
"telephone_number": "405-341-8490",
"fax_number": "405-341-8496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISAACS",
"first_name": "SUSAN",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "D.PH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-07",
"last_updated": "2020-04-27",
"certification_date": "2020-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "11706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.