Individual provider Active NPI

Kristopher Avery Kaye, RPH.

  • Pharmacist
  • Petoskey, MI
National Provider Identifier
1043533235
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302301094 Issued in MI
Practice address
1401 Spring St
Petoskey, MI 49770-2884
Phone
(231) 347-7281
NPI assigned
Mar 2, 2010
Last updated
Mar 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 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 5302301094 MI Primary

Addresses

Primary practice location

1401 Spring St
Petoskey, MI 49770-2884

Mailing address

3737 Pickerel Lake Rd
Petoskey, MI 49770-9326
Phone (231) 487-0778

Other identifiers 1

IdentifierTypeStateIssuer
5302031094OtherMIBOARD OF PHARMACY PRACTICE LICENSE

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

LicenseStateTypeSpecialty
5302301094MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1043533235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 PICKEREL LAKE RD",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709326",
            "telephone_number": "231-487-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SPRING ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702884",
            "telephone_number": "231-347-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYE",
        "first_name": "KRISTOPHER",
        "middle_name": "AVERY",
        "name_prefix": "Mr.",
        "credential": "RPH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-02",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302301094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY PRACTICE LICENSE",
            "identifier": "5302031094",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.