Mitchell Kisamore

Primary specialty

PharmacistTaxonomy code 183500000X

License

03439726 Issued in OH

Practice address

2630 Bailey Rd
Cuyahoga Falls, OH 44221-2216

Phone

(330) 923-5766

NPI assigned

May 8, 2021

Sex

Male

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

Practice roles

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.

• Fred W Albrecht Grocery Co

  • Pharmacy
  • Medina, OH
  • NPI 1467244368
  NPD (past)
• Fred W Albrecht Grocery Co

  • Pharmacy
  • Cuyahoga Falls, OH
  • NPI 1477568301
  NPD (past)

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

{
    "created_epoch": "1620432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620432000000",
    "number": "1003490798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 BAILEY RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442212216",
            "telephone_number": "330-923-5766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 BAILEY RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442212216",
            "telephone_number": "330-923-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISAMORE",
        "first_name": "MITCHELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-08",
        "last_updated": "2021-05-08",
        "certification_date": "2021-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03439726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn King, COTA/L
• Erin King, MSW, LSW
• Casey Kingsley, COTA/L
• Carmen Kiraly
• Karol Kirk, R.PH.
• Samantha Kisilewicz, ATC
• Kjohnstoncounseling
• Joanna R Kleckner, DDS
• Brandi Klein, RD
• Klein'S Assuremed Solutions, Inc.

• Pharmacist in Cuyahoga Falls, OH
• Providers in Cuyahoga Falls, OH by specialty
• Pharmacist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2021; 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.