Active NPI
Kimberly N Waerness, R.PH
- Pharmacist
- Scottsdale, AZ
National Provider Identifier
1023224078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12665
- Practice address
- 13400 E Shea Blvd
Scottsdale, AZ 85259-5404 - Phone
- (480) 301-8195
- NPI assigned
- May 15, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12665 | AZ | Primary |
Addresses
Primary practice location
13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Mailing address
9227 E Rusty Spur PL
Scottsdale, AZ 85255-6603
Phone (480) 342-7084
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 |
|---|---|---|---|
| 12665 | AZ | MD | Nutrition Education Nutritionist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023224078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9227 E RUSTY SPUR PL",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852556603",
"telephone_number": "480-342-7084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13400 E SHEA BLVD",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852595404",
"telephone_number": "480-301-8195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAERNESS",
"first_name": "KIMBERLY",
"middle_name": "N",
"name_prefix": "Mrs.",
"credential": "R.PH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "12665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.