Active NPI
Kyle Kennedy
- Pharmacist
- Tucson, AZ
National Provider Identifier
1033612601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S023141
- Practice address
- 3699 E Broadway Blvd
Tucson, AZ 85716-5400 - Phone
- (623) 693-2786
- NPI assigned
- Mar 9, 2018
- 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 | S023141 | AZ | Primary |
Addresses
Primary practice location
3699 E Broadway Blvd
Tucson, AZ 85716-5400
Mailing address
5025 N 1St Ave Apt 202
Tucson, AZ 85718-5657
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 |
|---|---|---|---|
| S023141 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520553600000",
"number": "1033612601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5025 N 1ST AVE APT 202",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857185657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3699 E BROADWAY BLVD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857165400",
"telephone_number": "623-693-2786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "KYLE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-03-09",
"last_updated": "2018-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S023141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.