Individual provider Active NPI

James Edward Kinscherff, R.PH.

  • Pharmacist
  • Freeport, IL
National Provider Identifier
1053448944
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
12115 Issued in WI
Practice address
1512 S West Ave
Freeport, IL 61032-6702
Phone
(815) 297-0881
Fax
(816) 297-0972
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 12115 WI Primary
Pharmacist 183500000X IL

Addresses

Primary practice location

1512 S West Ave
Freeport, IL 61032-6702

Mailing address

1512 S West Ave
Freeport, IL 61032-6702
Phone (815) 297-0881

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
051-031033ILMDPharmacist
12115WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Supervalu Pharmacies Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1053448944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 S WEST AVE",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326702",
            "telephone_number": "815-297-0881",
            "fax_number": "815-297-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 S WEST AVE",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326702",
            "telephone_number": "815-297-0881",
            "fax_number": "816-297-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSCHERFF",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "12115",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.