Active NPI
Colette Lynn Via, PHARMD
- Pharmacist
- New York, NY
National Provider Identifier
1609208586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 062865
- Practice address
- 100 Park Ave
Suite Front E
New York, NY 10017 - Phone
- (800) 874-5881
- NPI assigned
- Aug 2, 2013
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12169 | SC | |
| Pharmacist | 183500000X | 22405 | NC | |
| Pharmacist | 183500000X | 062865 | NY | Primary |
Addresses
Primary practice location
100 Park Ave
Suite Front E
New York, NY 10017
Mailing address
100 Park Ave
Suite Front E
New York, NY 10017
Phone (800) 874-5881
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 |
|---|---|---|---|
| 22405 | NC | MD | Pharmacist |
| 062865 | NY | MD | Pharmacist |
| 12169 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harris Teeter, LLC | Past | Accepting new patients | |
| Harris Teeter LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Apex, NC
- NPI 1225856859
-
- Community/Retail Pharmacy
- Raleigh, NC
- NPI 1194829523
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610496000000",
"number": "1609208586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 PARK AVE",
"address_2": "SUITE FRONT E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10017",
"telephone_number": "800-874-5881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 PARK AVE",
"address_2": "SUITE FRONT E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10017",
"telephone_number": "800-874-5881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIA",
"first_name": "COLETTE",
"middle_name": "LYNN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-02",
"last_updated": "2021-01-13",
"certification_date": "2021-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "12169",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "22405",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "062865",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.