Individual provider Active NPI

Jacquelyn Anne Kotten, RPH

  • Pharmacist
  • Steubenville, OH
National Provider Identifier
1508683228
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03439412 Issued in OH
Practice address
4100 Johnson Rd Ste 1054100
Steubenville, OH 43952-2356
Phone
(740) 264-8222
Fax
(740) 264-8233
NPI assigned
Sep 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03439412 OH Primary

Addresses

Primary practice location

4100 Johnson Rd Ste 1054100
Steubenville, OH 43952-2356

Mailing address

2433 Wylie Ridge Rd
Weirton, WV 26062-6051
Phone (304) 670-9174

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
03439412OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1508683228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2433 WYLIE RIDGE RD",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260626051",
            "telephone_number": "304-670-9174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHNSON RD STE 1054100",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "439522356",
            "telephone_number": "740-264-8222",
            "fax_number": "740-264-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTTEN",
        "first_name": "JACQUELYN",
        "middle_name": "ANNE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03439412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Steubenville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.