Individual provider Active NPI

Jason Nicholas Leuck, PHARM. D.

  • Pharmacist
  • Colchester, VT
National Provider Identifier
1073120069
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
033.0096326 Issued in VT
Practice address
218 Lower Mountain View Dr
Colchester, VT 05446
Phone
(802) 655-3156
Fax
(802) 654-7461
NPI assigned
Sep 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 033.0096326 VT Primary

Addresses

Primary practice location

218 Lower Mountain View Dr
Colchester, VT 05446

Mailing address

218 Lower Mountain View Dr
Colchester, VT 05446
Phone (802) 655-3156

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
033.0096326VTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1073120069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 LOWER MOUNTAIN VIEW DR",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "05446",
            "telephone_number": "802-655-3156",
            "fax_number": "802-654-7461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 LOWER MOUNTAIN VIEW DR",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "05446",
            "telephone_number": "802-655-3156",
            "fax_number": "802-654-7461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUCK",
        "first_name": "JASON",
        "middle_name": "NICHOLAS",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VT",
            "license": "033.0096326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colchester, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.

Verify at the official NPI Registry.