Jessica Kotschegarow

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

6783 Issued in SD

Practice address

2100 Broadway Ave
Yankton, SD 57078-1705

Phone

(605) 665-3412

NPI assigned

Oct 21, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604707200000",
    "number": "1972102952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 BROADWAY AVE",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570781705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 BROADWAY AVE",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570781705",
            "telephone_number": "605-665-3412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 Applewood Dr",
            "address_purpose": "LOCATION",
            "city": "Yankton",
            "state": "SD",
            "postal_code": "570785136",
            "country_code": "US",
            "telephone_number": "605-661-6003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTSCHEGAROW",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-11-07",
        "certification_date": "2020-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "SD",
            "license": "6783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Yankton, SD
• Providers in Yankton, SD by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.