Individual provider Active NPI

Kimberly Korotky

  • Pharmacist
  • Whiting, NJ
National Provider Identifier
1053917526
Registry record updated Nov 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03605300 Issued in NJ
Practice address
400 Lacey Rd
Whiting, NJ 08759-1325
Phone
(732) 716-1787
NPI assigned
Dec 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03605300 NJ Primary

Addresses

Primary practice location

400 Lacey Rd
Whiting, NJ 08759-1325

Mailing address

1381 Newark Ave
Whiting, NJ 08759-3911
Phone (609) 334-9546

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

LicenseStateTypeSpecialty
28RI03605300NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Saker Shoprites Inc PastSince Dec 1, 2020 Accepting new patients
The Stop & Shop Supermarket Company LLC PastSince Nov 26, 2023 Accepting new patients
Saker Shoprites Inc PastSince Dec 1, 2020 Accepting new patients
Stop and Shop Supermarket Co LLC PastSince Nov 26, 2023 Accepting new patients

Organizations & group practices 4

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": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700352000000",
    "number": "1053917526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1381 NEWARK AVE",
            "city": "WHITING",
            "state": "NJ",
            "postal_code": "087593911",
            "telephone_number": "609-334-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 LACEY RD",
            "city": "WHITING",
            "state": "NJ",
            "postal_code": "087591325",
            "telephone_number": "732-716-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROTKY",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-09",
        "last_updated": "2023-11-19",
        "certification_date": "2023-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03605300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiting, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2023; 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.