Active NPI
Travis Owen Lacore, PHARM.D.
- Pharmacist
- Kiester, MN
National Provider Identifier
1336404490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 118237
- Practice address
- 113 North 3Rd Street
Kiester, MN 56051 - Phone
- (507) 459-8421
- Fax
- (641) 298-1204
- NPI assigned
- Jul 5, 2012
- Last updated
- Jul 5, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 118237 | MN | Primary |
| Pharmacist | 183500000X | 21210 | IA | |
| Pharmacist | 183500000X | 5416 | SD |
Addresses
Primary practice location
113 North 3Rd Street
Kiester, MN 56051
Mailing address
P.O. Box 357
113 North 3Rd Street
Kiester, MN 56051
Phone (507) 459-8421
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 |
|---|---|---|---|
| 21210 | IA | MD | Pharmacist |
| 118237 | MN | MD | Pharmacist |
| 5416 | SD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341446400000",
"number": "1336404490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 357",
"address_2": "113 NORTH 3RD STREET",
"city": "KIESTER",
"state": "MN",
"postal_code": "56051",
"telephone_number": "507-459-8421",
"fax_number": "641-298-1204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 NORTH 3RD STREET",
"city": "KIESTER",
"state": "MN",
"postal_code": "56051",
"telephone_number": "507-459-8421",
"fax_number": "641-298-1204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACORE",
"first_name": "TRAVIS",
"middle_name": "OWEN",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-05",
"last_updated": "2012-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "118237",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "21210",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SD",
"license": "5416",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kiester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.