Individual provider Active NPI

Lisa Ann Cohn, PHARMD

  • Pharmacotherapy Pharmacist
  • San Fidel, NM
National Provider Identifier
1366612830
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
4710 Issued in SD
Practice address
Interstate 40 @ Exit 102
Acl Hospital Pharmacy Dept
San Fidel, NM 87049
Phone
(505) 552-5359
NPI assigned
Mar 11, 2008
Last updated
Mar 12, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 4710 SD Primary

Addresses

Primary practice location

Interstate 40 @ Exit 102
Acl Hospital Pharmacy Dept
San Fidel, NM 87049

Mailing address

Interstate 40 @ Exit 102
Acl Hospital Pharmacy Dept
San Fidel, NM 87049
Phone (505) 552-5359

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
4710SDMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1366612830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "INTERSTATE 40 @ EXIT 102",
            "address_2": "ACL HOSPITAL PHARMACY DEPT",
            "city": "SAN FIDEL",
            "state": "NM",
            "postal_code": "87049",
            "telephone_number": "505-552-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "INTERSTATE 40 @ EXIT 102",
            "address_2": "ACL HOSPITAL PHARMACY DEPT",
            "city": "SAN FIDEL",
            "state": "NM",
            "postal_code": "87049",
            "telephone_number": "505-552-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHN",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "SD",
            "license": "4710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Fidel, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.