Kimberly Marie Wheatcraft, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS53964 Issued in FL

Practice address

1930 State Road 44
New Smyrna Beach, FL 32168-8345

Phone

(386) 423-1173

Fax

(386) 423-9475

NPI assigned

Sep 14, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kimberly Marie Clifton Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1003284613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 STATE ROAD 44",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321688345",
            "telephone_number": "386-423-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 STATE ROAD 44",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321688345",
            "telephone_number": "386-423-1173",
            "fax_number": "386-423-9475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEATCRAFT",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-14",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS53964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH",
            "identifier": "PS53964",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "CLIFTON",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pharmacist in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.

Verify at the official NPI Registry.