Active NPI
Collin James Kruczek, PHARMD
- Ambulatory Care Pharmacist
- Charlotte, NC
National Provider Identifier
1659258945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 33223
- Practice address
- 1940 West Blvd
Charlotte, NC 28208 - Phone
- (980) 402-1660
- NPI assigned
- Aug 19, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 33223 | NC | Primary |
Addresses
Primary practice location
1940 West Blvd
Charlotte, NC 28208
Mailing address
1940 West Blvd
Charlotte, NC 28208
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 |
|---|---|---|---|
| 33223 | NC | MD | Ambulatory Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763424000000",
"number": "1659258945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1940 WEST BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1940 WEST BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28208",
"telephone_number": "980-402-1660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUCZEK",
"first_name": "COLLIN",
"middle_name": "JAMES",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-19",
"last_updated": "2025-11-18",
"certification_date": "2025-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "NC",
"license": "33223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.