Active NPI
Matthew O'Connor
- Pharmacist
- Essex Junction, VT
National Provider Identifier
1982051066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 033.0003717
- Practice address
- 90 Center Rd
Essex Junction, VT 05452-2658 - Phone
- (802) 879-4155
- Fax
- (802) 878-7448
- NPI assigned
- May 19, 2016
- Last updated
- May 19, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | 033.0003717 | VT | Primary |
Addresses
Primary practice location
90 Center Rd
Essex Junction, VT 05452-2658
Mailing address
90 Center Rd
Essex Junction, VT 05452-2658
Phone (802) 879-4155
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 033.0003717 | Other | VT | STATE LICENSE |
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 |
|---|---|---|---|
| 033.0003717 | VT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vermont Family Pharmacy Inc | Current | Accepting new patients | |
| Golub Corporation | Past | Accepting new patients | |
| Price Chopper Operating Co of Vermont Inc | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Vermont Family Pharmacy
- Community/Retail Pharmacy
- Burlington, VT
- NPI 1457455420
-
- Community/Retail Pharmacy
- Burlington, VT
- NPI 1083727002
-
dba Price Chopper Pharmacy
- Community/Retail Pharmacy
- Essex Junction, VT
- NPI 1518070986
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463616000000",
"number": "1982051066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 CENTER RD",
"city": "ESSEX JUNCTION",
"state": "VT",
"postal_code": "054522658",
"telephone_number": "802-879-4155",
"fax_number": "802-878-7448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 CENTER RD",
"city": "ESSEX JUNCTION",
"state": "VT",
"postal_code": "054522658",
"telephone_number": "802-879-4155",
"fax_number": "802-878-7448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "MATTHEW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-05-19",
"last_updated": "2016-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VT",
"license": "033.0003717",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "033.0003717",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Essex Junction, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.