Individual provider Active NPI

Kimberly Ann Vollstedt, PHARMD

  • Pharmacist
  • Audubon, IA
National Provider Identifier
1013239649
Registry record updated Feb 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19529 Issued in IA
Practice address
109 N Market St
Audubon, IA 50025-1173
Phone
(712) 563-3302
Fax
(712) 563-3404
NPI assigned
Feb 24, 2010
Last updated
Feb 24, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19529 IA Primary

Addresses

Primary practice location

109 N Market St
Audubon, IA 50025-1173

Mailing address

109 N Market St
Audubon, IA 50025-1173
Phone (712) 563-3302

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
19529IAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rex Pharmacy Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1266969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1013239649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N MARKET ST",
            "city": "AUDUBON",
            "state": "IA",
            "postal_code": "500251173",
            "telephone_number": "712-563-3302",
            "fax_number": "712-563-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N MARKET ST",
            "city": "AUDUBON",
            "state": "IA",
            "postal_code": "500251173",
            "telephone_number": "712-563-3302",
            "fax_number": "712-563-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLLSTEDT",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-24",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "19529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Audubon, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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.