Individual provider Active NPI

Thomas Ditch, PHARMD

  • Pharmacist
  • Fayetteville, NY
National Provider Identifier
1164064309
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
064915 Issued in NY
Practice address
340 Towne Dr
Fayetteville, NY 13066-1371
Phone
(315) 546-4348
NPI assigned
Oct 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 064915 NY Primary

Addresses

Primary practice location

340 Towne Dr
Fayetteville, NY 13066-1371

Mailing address

340 Towne Dr
Fayetteville, NY 13066-1371
Phone (315) 546-4348

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL CVS Direct

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
064915NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1164064309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 TOWNE DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661371",
            "telephone_number": "315-546-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 TOWNE DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661371",
            "telephone_number": "315-546-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITCH",
        "first_name": "THOMAS",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-09",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "064915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CVS",
            "affiliation": "N",
            "endpointDescription": "CVS PHARMACY",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "340 Towne Dr",
            "city": "Fayetteville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "130661371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; 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.