Active NPI
Khristine S Lariviere, RPH
- Pharmacist
- Uncasville, CT
National Provider Identifier
1912273194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3455
- Practice address
- 67 Sandy Desert Rd
Uncasville, CT 06382-1111 - Phone
- (855) 664-4679
- Fax
- (860) 862-9099
- NPI assigned
- Apr 1, 2012
- Last updated
- Jan 31, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3455 | NH | Primary |
| Pharmacist | 183500000X | 18362 | KY | |
| Pharmacist | 183500000X | 18120 | AL | |
| Pharmacist | 183500000X | PH232932 | MA | |
| Pharmacist | 183500000X | S021075 | AZ | |
| Pharmacist | 183500000X | RPH04838 | RI | |
| Pharmacist | 183500000X | 202212884 | VA | |
| Pharmacist | 183500000X | 59689 | TX | |
| Pharmacist | 183500000X | 37926 | TN | |
| Pharmacist | 183500000X | RPH-0014832 | OR | |
| Pharmacist | 183500000X | PST.021988 | LA | |
| Pharmacist | 183500000X | 16737 | OK | |
| Pharmacist | 183500000X | MD23345 | MD | |
| Pharmacist | 183500000X | PCT.0011317 | CT | |
| Pharmacist | 183500000X | T-13794 | MS |
Addresses
Primary practice location
67 Sandy Desert Rd
Uncasville, CT 06382-1111
Mailing address
58 Tum a Lum Cir
Westerly, RI 02891-3156
Phone (860) 460-6743
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59689 | TX | MD | Clinical Social Worker |
| 18120 | AL | MD | Pharmacist |
| S021075 | AZ | MD | Pharmacist |
| PCT.0011317 | CT | MD | Pharmacist |
| 18362 | KY | MD | Pharmacist |
| PST.021988 | LA | MD | Pharmacist |
| PH232932 | MA | MD | Pharmacist |
| MD23345 | MD | MD | Pharmacist |
| T-13794 | MS | MD | Pharmacist |
| 16737 | OK | MD | Pharmacist |
| RPH-0014832 | OR | MD | Pharmacist |
| RPH04838 | RI | MD | Pharmacist |
| 202212884 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mohegan Tribe of Indians of CT | Current | Accepting new patients | |
| Mohegan Tribe of Indians of Connecticut | Current | Accepting new patients |
Locations
67 Sandy Desert Rd
Uncasville, CT 06382
Phone (855) 664-4679
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.
-
- Ambulance
- Uncasville, CT
- NPI 1467442863
-
dba Mohegan Pharmacy
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Uncasville, CT
- NPI 1326313677
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643587200000",
"number": "1912273194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "58 TUM A LUM CIR",
"city": "WESTERLY",
"state": "RI",
"postal_code": "028913156",
"telephone_number": "860-460-6743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 SANDY DESERT RD",
"city": "UNCASVILLE",
"state": "CT",
"postal_code": "063821111",
"telephone_number": "855-664-4679",
"fax_number": "860-862-9099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARIVIERE",
"first_name": "KHRISTINE",
"middle_name": "S",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-01",
"last_updated": "2022-01-31",
"certification_date": "2022-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NH",
"license": "3455",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "18362",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "18120",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH232932",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S021075",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "RI",
"license": "RPH04838",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "202212884",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "59689",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "37926",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0014832",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.021988",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "16737",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "MD23345",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0011317",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "T-13794",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Uncasville, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.