Individual provider Active NPI

Renee Marie Deichert, RPH

  • Pharmacist
  • Colchester, CT
National Provider Identifier
1619276227
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8790 Issued in CT
Practice address
27 Broadway St
Colchester, CT 06415-1001
Phone
(860) 537-9034
Fax
(860) 537-9023
NPI assigned
Mar 22, 2011
Last updated
Mar 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8790 CT Primary

Addresses

Primary practice location

27 Broadway St
Colchester, CT 06415-1001

Mailing address

27 Broadway St
Colchester, CT 06415-1001
Phone (860) 537-9034

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
8790CTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1619276227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 BROADWAY ST",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "064151001",
            "telephone_number": "860-537-9034",
            "fax_number": "860-537-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 BROADWAY ST",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "064151001",
            "telephone_number": "860-537-9034",
            "fax_number": "860-537-9023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEICHERT",
        "first_name": "RENEE",
        "middle_name": "MARIE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-22",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "8790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.