Kim Phan, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

25038 Issued in MD

Practice address

425 Lowell Ave
Haverhill, MA 01832

Phone

(978) 373-1234

NPI assigned

Nov 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1542931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1023587763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 9TH AVE",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018303203",
            "telephone_number": "774-253-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 LOWELL AVE",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "01832",
            "telephone_number": "978-373-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Twin Arch Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Airy",
            "state": "MD",
            "postal_code": "217714138",
            "country_code": "US",
            "telephone_number": "301-829-1499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 Lowell Ave",
            "address_purpose": "LOCATION",
            "city": "Haverhill",
            "state": "MA",
            "postal_code": "01832",
            "country_code": "US",
            "telephone_number": "978-373-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "KIM",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-23",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "25038",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH238416",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Perry, LCSW
• Sofia Petalidas
• Peter C Moran MD
• Peter L Manis DMD PC
• Tu Pham
• Helen Phillips, LLMT
• Jorge Piccole
• Andrew R Piercey
• Rebecca Danielle Piercey
• Gerardine Pierre

• Pharmacist in Haverhill, MA
• Providers in Haverhill, MA by specialty
• Pharmacist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.