Individual provider Active NPI

Nicole L Peer, RPH

  • Pharmacist
  • Watertown, NY
National Provider Identifier
1154448041
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
044642 Issued in NY
Practice address
21082 Pioneer Plaza Dr
Watertown, NY 13601-5500
Phone
(315) 788-0146
Fax
(315) 788-0620
NPI assigned
Mar 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 044642 NY Primary

Addresses

Primary practice location

21082 Pioneer Plaza Dr
Watertown, NY 13601-5500

Mailing address

21082 Pioneer Plaza Dr
Watertown, NY 13601-5500
Phone (315) 788-0146

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

LicenseStateTypeSpecialty
044642NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154448041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21082 PIONEER PLAZA DR",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136015500",
            "telephone_number": "315-788-0146",
            "fax_number": "315-788-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21082 PIONEER PLAZA DR",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136015500",
            "telephone_number": "315-788-0146",
            "fax_number": "315-788-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEER",
        "first_name": "NICOLE",
        "middle_name": "L",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "044642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.