Active NPI
John Kenneth Nicol, PHARMD
- Pharmacist
- Wethersfield, CT
National Provider Identifier
1316494131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT.0013920
- Practice address
- 1100 Silas Deane Hwy
Wethersfield, CT 06109-4232 - Phone
- (860) 721-7224
- NPI assigned
- Sep 9, 2016
- Sex
- Male
- 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 | PCT.0013920 | CT | Primary |
Addresses
Primary practice location
1100 Silas Deane Hwy
Wethersfield, CT 06109-4232
Mailing address
25 Garden St
Manchester, CT 06040-5008
Phone (860) 933-5771
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
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0013920 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co Inc | Past | Accepting new patients | |
| Walgreen Eastern Co 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473379200000",
"number": "1316494131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 GARDEN ST",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060405008",
"telephone_number": "860-933-5771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 SILAS DEANE HWY",
"city": "WETHERSFIELD",
"state": "CT",
"postal_code": "061094232",
"telephone_number": "860-721-7224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOL",
"first_name": "JOHN",
"middle_name": "KENNETH",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-09",
"last_updated": "2016-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0013920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wethersfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.