Active NPI
Kyle Wilson
- Pharmacist
- Rochester, IN
National Provider Identifier
1013396787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26025146A
- Practice address
- 906 Main St
Rochester, IN 46975-1740 - Phone
- (574) 223-3249
- NPI assigned
- May 27, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26025146A | IN | Primary |
Addresses
Primary practice location
906 Main St
Rochester, IN 46975-1740
Mailing address
906 Main St
Rochester, IN 46975-1740
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26025146A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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
- Rochester, IN
- NPI 1669487781
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432684800000",
"number": "1013396787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "906 MAIN ST",
"city": "ROCHESTER",
"state": "IN",
"postal_code": "469751740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "906 MAIN ST",
"city": "ROCHESTER",
"state": "IN",
"postal_code": "469751740",
"telephone_number": "574-223-3249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KYLE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-27",
"last_updated": "2015-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26025146A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.