Active NPI
Kristy L Liddic, PHARM D
- Pharmacist
- Nottingham, MD
National Provider Identifier
1063633097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17971
- Practice address
- 8669 Belair Rd
Nottingham, MD 21236-2703 - Phone
- (410) 256-2844
- Fax
- (410) 256-5376
- NPI assigned
- May 1, 2007
- Last updated
- Nov 22, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17971 | MD | Primary |
| Pharmacist | 183500000X | 0202206183 | VA |
Addresses
Primary practice location
8669 Belair Rd
Nottingham, MD 21236-2703
Mailing address
1203 Leeds CT
Abingdon, MD 21009
Phone (410) 676-0240
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17971 | MD | MD | Pharmacist |
| 0202206183 | VA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Carolina CVS Pharmacy LLC | 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, 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": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448150400000",
"number": "1063633097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1203 LEEDS CT",
"city": "ABINGDON",
"state": "MD",
"postal_code": "21009",
"telephone_number": "410-676-0240",
"fax_number": "410-420-9068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8669 BELAIR RD",
"city": "NOTTINGHAM",
"state": "MD",
"postal_code": "212362703",
"telephone_number": "410-256-2844",
"fax_number": "410-256-5376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIDDIC",
"first_name": "KRISTY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2015-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "17971",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202206183",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nottingham, MD
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.