Active NPI
Kim Pham, PHARMD
- Pharmacist
- Blue Springs, MO
National Provider Identifier
1063930857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16291
- Practice address
- 1701 NW State Route 7
Blue Springs, MO 64014-1913 - Phone
- (816) 220-3620
- NPI assigned
- Sep 1, 2017
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16291 | OK | Primary |
| Pharmacist | 183500000X | 2020015960 | MO | |
| Pharmacist | 183500000X | 1-111537 | KS |
Addresses
Primary practice location
1701 NW State Route 7
Blue Springs, MO 64014-1913
Mailing address
1591 SW Manor Lake Dr
Lees Summit, MO 64082-4186
Phone (918) 605-5920
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 |
|---|---|---|---|
| 1-111537 | KS | MD | Pharmacist |
| 2020015960 | MO | MD | Pharmacist |
| 16291 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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": "1504224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613779200000",
"number": "1063930857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1591 SW MANOR LAKE DR",
"city": "LEES SUMMIT",
"state": "MO",
"postal_code": "640824186",
"telephone_number": "918-605-5920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 NW STATE ROUTE 7",
"city": "BLUE SPRINGS",
"state": "MO",
"postal_code": "640141913",
"telephone_number": "816-220-3620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "KIM",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-01",
"last_updated": "2021-02-20",
"certification_date": "2021-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "16291",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2020015960",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KS",
"license": "1-111537",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Springs, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.