Jeremiah Vincent

Primary specialty

PharmacistTaxonomy code 183500000X

License

056700 Issued in NY

Practice address

540 Genesee St
Chittenango, NY 13037-1606

Phone

(315) 687-6110

NPI assigned

Sep 7, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• KPH Healthcare Services, Inc.

  • Community/Retail Pharmacy
  • Syracuse, NY
  • NPI 1013024298
  NPD (past)
• KPH Healthcare Services, Inc.

  • Community/Retail Pharmacy
  • Chittenango, NY
  • NPI 1831206010
  NPD (past)
• KPH Healthcare Services, Inc.

  • Community/Retail Pharmacy
  • Brattleboro, VT
  • NPI 1407747157
  NPD (past)

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1487903209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4731 PRESTWICK DR",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131049745",
            "telephone_number": "518-312-9956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 GENESEE ST",
            "city": "CHITTENANGO",
            "state": "NY",
            "postal_code": "130371606",
            "telephone_number": "315-687-6110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4731 Prestwick Dr",
            "address_purpose": "LOCATION",
            "city": "Manlius",
            "state": "NY",
            "postal_code": "131049745",
            "country_code": "US",
            "telephone_number": "518-312-9956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4202 W Genesee St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132191936",
            "country_code": "US",
            "telephone_number": "315-487-0326",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4202 W Genesee St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132191936",
            "country_code": "US",
            "telephone_number": "315-487-0326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "JEREMIAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-07",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "056700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sue Anne Thomas, MS, CCC, SLP
• Joyce Tibbett, DO
• Ola Marie Trieb
• Joseph Vieau III, PHARMD
• Anthony Vigliotti, M.D.
• Waldron Physiotherapy, PLLC
• Walgreen Co
• Kathryn Reilly Wardell, OTR/L
• David Ware, DPT
• Matthew Watson, DPT

• All providers in Chittenango, NY
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.