Active NPI
Susan M Lang, PHARMACIST
- Pharmacist
- Peabody, MA
National Provider Identifier
1962006916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH18403
- Practice address
- 100 Brooksby Village Dr
Peabody, MA 01960-1438 - Phone
- (978) 326-2350
- Fax
- (978) 536-6937
- NPI assigned
- Nov 30, 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 | PH18403 | MA | Primary |
Addresses
Primary practice location
100 Brooksby Village Dr
Peabody, MA 01960-1438
Mailing address
47 Oak Ridge Cir
Lynn, MA 01904-1527
Phone (781) 690-3547
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Peabody | Direct | Main Street Pharmacy, LLC |
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 |
|---|---|---|---|
| PH18403 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1962006916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 OAK RIDGE CIR",
"city": "LYNN",
"state": "MA",
"postal_code": "019041527",
"telephone_number": "781-690-3547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 BROOKSBY VILLAGE DR",
"city": "PEABODY",
"state": "MA",
"postal_code": "019601438",
"telephone_number": "978-326-2350",
"fax_number": "978-536-6937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANG",
"first_name": "SUSAN",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-30",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH18403",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Peabody",
"affiliation": "Y",
"endpointDescription": "100 Brooksby Village Drive",
"affiliationName": "Main Street Pharmacy, LLC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "100 Brooksby Village Dr",
"city": "Peabody",
"state": "MA",
"country_code": "US",
"postal_code": "019601438",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Peabody, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.