Active NPI
Kendra Phillips Edlin
- Pharmacist
- Huntsville, AL
National Provider Identifier
1063612398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11940
- Practice address
- 9020 Bailey Cove Rd SE
Huntsville, AL 35802-4002 - Phone
- (256) 882-9250
- NPI assigned
- Jul 24, 2007
- Sex
- Female
- 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 | 11940 | AL | Primary |
Addresses
Primary practice location
9020 Bailey Cove Rd SE
Huntsville, AL 35802-4002
Mailing address
1229 Meadow Park Dr SE
Huntsville, AL 35803-3621
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3633 | Medicaid | AL |
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 |
|---|---|---|---|
| 11940 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185235200000",
"number": "1063612398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1229 MEADOW PARK DR SE",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358033621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9020 BAILEY COVE RD SE",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358024002",
"telephone_number": "256-882-9250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDLIN",
"first_name": "KENDRA",
"middle_name": "PHILLIPS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-24",
"last_updated": "2007-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "11940",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3633",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntsville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.