Katlin May Cicchetti, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

P7950 Issued in ID

Practice address

121 W Neider Ave
Coeur D Alene, ID 83815-9300

Phone

(208) 765-4410

Fax

(208) 765-0451

NPI assigned

Aug 25, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Katlin May Cormier Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Safeway Inc

  • Community/Retail Pharmacy
  • Coeur D Alene, ID
  • NPI 1164468781
  NPD (past)
• Safeway Inc

  • Community/Retail Pharmacy
  • Queen Creek, AZ
  • NPI 1730040973
  NPD (past)

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1154848547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13198 N TELLURIDE LOOP",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838353308",
            "telephone_number": "509-855-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W NEIDER AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159300",
            "telephone_number": "208-765-4410",
            "fax_number": "208-765-0451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCHETTI",
        "first_name": "KATLIN",
        "middle_name": "MAY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60749814",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P7950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATLIN",
            "last_name": "CORMIER",
            "middle_name": "MAY",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chrysalis Inc
• Chrysalis Inc
• Chrysalis Inc
• Chrysalis, Inc.
• Steven Emmet Ciabattoni, MD
• Cinch Health PLLC
• Casey L Cinkovich, LCPC
• Angela Ruth Clancy, LCPC
• Roy Lavern Clapper, OD
• Emalie Clark

• All providers in Coeur D Alene, ID
• Pharmacist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.