Active NPI
Cody Kibbee
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Montgomery, TX
National Provider Identifier
1063146777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 68761
- Practice address
- 20168 Eva St
Montgomery, TX 77356-2006 - Phone
- (936) 449-7167
- NPI assigned
- Jul 11, 2022
- Last updated
- Jul 11, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 68761 | TX | Primary |
Addresses
Primary practice location
20168 Eva St
Montgomery, TX 77356-2006
Mailing address
20168 Eva St
Montgomery, TX 77356-2006
Phone (936) 449-7167
Other practice location 1
3535 Longmire Dr
College Station, TX 77845-5271
Phone (979) 485-8813
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 |
|---|---|---|---|
| 68761 | TX | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Texas LP | Past | Accepting new patients | |
| Kroger Texas L P | Past | Accepting new patients | |
| Kroger Texas L P | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657497600000",
"number": "1063146777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20168 EVA ST",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "773562006",
"telephone_number": "936-449-7167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20168 EVA ST",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "773562006",
"telephone_number": "936-449-7167"
}
],
"practiceLocations": [
{
"address_1": "3535 Longmire Dr",
"address_purpose": "LOCATION",
"city": "College Station",
"state": "TX",
"postal_code": "778455271",
"country_code": "US",
"telephone_number": "979-485-8813",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIBBEE",
"first_name": "CODY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-07-11",
"last_updated": "2022-07-11",
"certification_date": "2021-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "TX",
"license": "68761",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, TX
- Agnes C. Kaufman, DC
- Cheryl Deon Keith
- Jadesola Kelani, MSN, APRN, FNP-C
- Brenda Kenner, M.S.,CCC-SLP
- Trisha Bowen Kerr, LPC, RN, CNS PMH,CEA
- Kelly Ann Kilpatrick, LPC-S
- Kingwood Physical Therapy LTD. (Lake Conroe Sports Medicine and Rehabilitation)
- Robert Albert Knapick, LMFT
- Knee Scooters Houston LLC
- Knee Scooters Houston, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.