Active NPI
Sarah Provencher
- Pharmacist
- Tolland, CT
National Provider Identifier
1114514965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0014807
- Practice address
- 33 Fieldstone CMNS
Tolland, CT 06084-3418 - Phone
- (860) 872-0369
- Fax
- (860) 872-0696
- NPI assigned
- Dec 28, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 0014807 | CT | Primary |
Addresses
Primary practice location
33 Fieldstone CMNS
Tolland, CT 06084-3418
Mailing address
33 Fieldstone CMNS
Tolland, CT 06084-3418
Phone (860) 872-0369
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 |
|---|---|---|---|
| 0014807 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Big Y Foods, Inc | Past | Accepting new patients | |
| Big Y Foods Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Tolland, CT
- NPI 1215026844
-
- Community/Retail Pharmacy
- Mystic, CT
- NPI 1700194867
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609113600000",
"number": "1114514965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 FIELDSTONE CMNS",
"city": "TOLLAND",
"state": "CT",
"postal_code": "060843418",
"telephone_number": "860-872-0369",
"fax_number": "860-872-0696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 FIELDSTONE CMNS",
"city": "TOLLAND",
"state": "CT",
"postal_code": "060843418",
"telephone_number": "860-872-0369",
"fax_number": "860-872-0696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROVENCHER",
"first_name": "SARAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-28",
"last_updated": "2020-12-28",
"certification_date": "2020-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "0014807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tolland, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.