Individual provider Active NPI

Kimberlee Sue Auth, RPH

  • Pharmacist
  • New York, NY
National Provider Identifier
1003418864
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
I064109 Issued in NY
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

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
210521OtherNABP EPROFILE ID
I064109OtherNYPHARMACIST 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

LicenseStateTypeSpecialty
52294CAMDPharmacist
051.286990ILMDPharmacist
I064109NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Albany LLC PastSince Nov 22, 2020 Accepting new patients
CVS Albany LLC PastSince Nov 22, 2020 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.

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.

Verify at the official NPI Registry.