Active NPI
Kanish Keyur Amin
- Pharmacist
- Winston Salem, NC
National Provider Identifier
1083213490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 29742
- Practice address
- 3475 Parkway Village Cir
Winston Salem, NC 27127-6857 - Phone
- (336) 771-7911
- NPI assigned
- Oct 19, 2020
- Sex
- Male
- 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 | 0202215119 | VA | |
| Pharmacist | 183500000X | 29742 | NC | Primary |
Addresses
Primary practice location
3475 Parkway Village Cir
Winston Salem, NC 27127-6857
Mailing address
320 E Hanes Mill Rd
Winston Salem, NC 27105-9135
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 |
|---|---|---|---|
| 29742 | NC | MD | Pharmacist |
| 0202215119 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731628800000",
"number": "1083213490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 E HANES MILL RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271059135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3475 PARKWAY VILLAGE CIR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271276857",
"telephone_number": "336-771-7911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMIN",
"first_name": "KANISH",
"middle_name": "KEYUR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-19",
"last_updated": "2024-11-15",
"certification_date": "2024-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202215119",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "29742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.