Active NPI
Thomas Lee Sandison, R.PH.
- Pharmacist
- Petoskey, MI
National Provider Identifier
1962427401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302026140
- Practice address
- 1250 Lears Rd
Petoskey, MI 49770-9252 - Phone
- (231) 242-1667
- Fax
- (231) 242-1667
- NPI assigned
- Jul 13, 2006
- 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 | 5302026140 | MI | Primary |
Addresses
Primary practice location
1250 Lears Rd
Petoskey, MI 49770-9252
Mailing address
12955 Robins Ridge Rd
Charlevoix, MI 49720-8974
Phone (231) 547-5280
Other practice location 1
601 Bridge St
East Jordan, MI 49727-9383
Phone (231) 536-2207
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302026140 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1962427401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12955 ROBINS RIDGE RD",
"city": "CHARLEVOIX",
"state": "MI",
"postal_code": "497208974",
"telephone_number": "231-547-5280",
"fax_number": "231-536-7739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 LEARS RD",
"city": "PETOSKEY",
"state": "MI",
"postal_code": "497709252",
"telephone_number": "231-242-1667",
"fax_number": "231-242-1667"
}
],
"practiceLocations": [
{
"address_1": "601 Bridge St",
"address_purpose": "LOCATION",
"city": "East Jordan",
"state": "MI",
"postal_code": "497279383",
"country_code": "US",
"telephone_number": "231-536-2207",
"fax_number": "231-536-7739",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANDISON",
"first_name": "THOMAS",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302026140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Petoskey, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.