Active NPI
Matt S Kotch
- Pharmacist
- High Point, NC
National Provider Identifier
1881985141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21196
- Practice address
- 1050 Mall Loop Rd
Target Pharmacy 1079
High Point, NC 27262-7656 - Phone
- (336) 884-1260
- Fax
- (336) 884-1260
- NPI assigned
- Apr 21, 2011
- Last updated
- Apr 21, 2011
- 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 | 21196 | NC | Primary |
Addresses
Primary practice location
1050 Mall Loop Rd
Target Pharmacy 1079
High Point, NC 27262-7656
Mailing address
2380 Carlyle Place Dr
Apt 104
Winston Salem, NC 27103-5063
Phone (336) 293-8379
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21196 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1303344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303344000000",
"number": "1881985141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2380 CARLYLE PLACE DR",
"address_2": "APT 104",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271035063",
"telephone_number": "336-293-8379",
"fax_number": "336-884-1260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 MALL LOOP RD",
"address_2": "TARGET PHARMACY 1079",
"city": "HIGH POINT",
"state": "NC",
"postal_code": "272627656",
"telephone_number": "336-884-1260",
"fax_number": "336-884-1260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTCH",
"first_name": "MATT",
"middle_name": "S",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-21",
"last_updated": "2011-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "21196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in High Point, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.