Individual provider Active NPI

Afix Kehinde

  • Pharmacist
  • Texarkana, TX
National Provider Identifier
1083215891
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
52757 Issued in TX
Practice address
4000 New Boston Rd
Texarkana, TX 75501-2819
Phone
(903) 831-3023
Fax
(903) 831-3023
NPI assigned
Nov 6, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 52757 TX Primary

Addresses

Primary practice location

4000 New Boston Rd
Texarkana, TX 75501-2819

Mailing address

4000 New Boston Rd
Texarkana, TX 75501-2819

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

LicenseStateTypeSpecialty
52757TXMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1083215891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 NEW BOSTON RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755012819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 NEW BOSTON RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755012819",
            "telephone_number": "903-831-3023",
            "fax_number": "903-831-3023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEHINDE",
        "first_name": "AFIX",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "52757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.