Individual provider Active NPI

Pierce Monroe Kocjan, PHARMD

  • Pharmacist
  • West Lebanon, NH
National Provider Identifier
1689260655
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHCY-00986 Issued in NH
Practice address
250 Plainfield Rd
West Lebanon, NH 03784-2000
Phone
(603) 298-8350
Fax
(603) 298-0547
NPI assigned
Dec 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 033.0134355 VT
Pharmacist 183500000X PCT.0015145 CT
Pharmacist 183500000X PH238714 MA
Pharmacist 183500000X PHCY-00986 NH Primary

Addresses

Primary practice location

250 Plainfield Rd
West Lebanon, NH 03784-2000

Mailing address

4 Semb Dr
Erving, MA 01344-4414
Phone (413) 422-1191

Other practice location 1

201 Highland St
Clinton, MA 01510-1037
Phone (978) 368-3774

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

LicenseStateTypeSpecialty
PCT.0015145CTMDPharmacist
PH238714MAMDPharmacist
PHCY-00986NHMDPharmacist
033.0134355VTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of New Hampshire, L.L.C. CurrentSince Dec 16, 2020 Accepting new patients
CVS Manchester NH L.L.C. PastSince Dec 16, 2020 Accepting new patients

Locations

250 Plainfield Rd
West Lebanon, NH 03784
Phone (603) 298-8350

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.

NPI Registry JSON

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1689260655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SEMB DR",
            "city": "ERVING",
            "state": "MA",
            "postal_code": "013444414",
            "telephone_number": "413-422-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PLAINFIELD RD",
            "city": "WEST LEBANON",
            "state": "NH",
            "postal_code": "037842000",
            "telephone_number": "603-298-8350",
            "fax_number": "603-298-0547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Highland St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MA",
            "postal_code": "015101037",
            "country_code": "US",
            "telephone_number": "978-368-3774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCJAN",
        "first_name": "PIERCE",
        "middle_name": "MONROE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VT",
            "license": "033.0134355",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0015145",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH238714",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NH",
            "license": "PHCY-00986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lebanon, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.

Verify at the official NPI Registry.