Active NPI
Kristen Alyson Nolan, PHARMD
- Community/Retail Pharmacy
- Plymouth, IN
National Provider Identifier
1578150504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 26023706A
- Practice address
- 865 E Jefferson St
Plymouth, IN 46563-1847 - Phone
- (574) 936-7334
- NPI assigned
- Dec 23, 2020
- Last updated
- Dec 23, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26023706A | IN | |
| Community/Retail Pharmacy | 3336C0003X | 26023706A | IN | Primary |
Addresses
Primary practice location
865 E Jefferson St
Plymouth, IN 46563-1847
Mailing address
865 E Jefferson St
Plymouth, IN 46563-1847
Phone (574) 936-7334
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 |
|---|---|---|---|
| 26023706A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MSM Holdco, LLC | Community/Retail Pharmacy | Current | Accepting new patients |
Locations
865 E Jefferson St
Plymouth, IN 46563
Phone (574) 936-4081
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608681600000",
"number": "1578150504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "865 E JEFFERSON ST",
"city": "PLYMOUTH",
"state": "IN",
"postal_code": "465631847",
"telephone_number": "574-936-7334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "865 E JEFFERSON ST",
"city": "PLYMOUTH",
"state": "IN",
"postal_code": "465631847",
"telephone_number": "574-936-7334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLAN",
"first_name": "KRISTEN",
"middle_name": "ALYSON",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-23",
"last_updated": "2020-12-23",
"certification_date": "2020-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26023706A",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "IN",
"license": "26023706A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plymouth, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.