Active NPI
Kimberlee Sue Auth, RPH
- Pharmacist
- New York, NY
National Provider Identifier
1003418864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- I064109
- Practice address
- 1569 1St Ave
New York, NY 10028-4003 - Phone
- (212) 249-5198
- NPI assigned
- Nov 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.286990 | IL | |
| Pharmacist | 183500000X | 52294 | CA | |
| Pharmacist | 183500000X | I064109 | NY | Primary |
Addresses
Primary practice location
1569 1St Ave
New York, NY 10028-4003
Mailing address
317 E 89TH St Apt 1E
New York, NY 10128-5073
Phone (309) 830-1837
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 210521 | Other | NABP EPROFILE ID | |
| I064109 | Other | NY | PHARMACIST STATE LICENSE NUMBER |
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 |
|---|---|---|---|
| 52294 | CA | MD | Pharmacist |
| 051.286990 | IL | MD | Pharmacist |
| I064109 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Pharmacy
- New York, NY
- NPI 1922102763
-
- Pharmacy
- Brooklyn, RI
- NPI 1679459481
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1003418864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "317 E 89TH ST APT 1E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101285073",
"telephone_number": "309-830-1837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1569 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100284003",
"telephone_number": "212-249-5198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUTH",
"first_name": "KIMBERLEE",
"middle_name": "SUE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-16",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.286990",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "52294",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "I064109",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP EPROFILE ID",
"identifier": "210521",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST STATE LICENSE NUMBER",
"identifier": "I064109",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.