Active NPI
Nicholas Tyler McInnis, PHARMD
- Pharmacist
- Hamden, CT
National Provider Identifier
1679175970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT.0015378
- Practice address
- 1697 Whitney Ave
Hamden, CT 06517-1936 - Phone
- (203) 288-5217
- NPI assigned
- Nov 11, 2020
- Last updated
- Dec 20, 2022
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PCT.0015378 | CT | Primary |
Addresses
Primary practice location
1697 Whitney Ave
Hamden, CT 06517-1936
Mailing address
1697 Whitney Ave
Hamden, CT 06517-1936
Phone (203) 230-0610
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 |
|---|---|---|---|
| PCT.0015378 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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, 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": "1605052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671494400000",
"number": "1679175970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1697 WHITNEY AVE",
"city": "HAMDEN",
"state": "CT",
"postal_code": "065171936",
"telephone_number": "203-230-0610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1697 WHITNEY AVE",
"city": "HAMDEN",
"state": "CT",
"postal_code": "065171936",
"telephone_number": "203-288-5217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINNIS",
"first_name": "NICHOLAS",
"middle_name": "TYLER",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-11",
"last_updated": "2022-12-20",
"certification_date": "2022-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0015378",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamden, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.