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
- 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 and National Provider Directory roles.
-
- Pharmacy
- Winston Salem, NC
- NPI 1699797258
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.