Active NPI
Kyle Goodrich, PHARMD.
- Pharmacist
- Corning, NY
National Provider Identifier
1083362685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 068026
- Practice address
- 24 S Bridge St
Corning, NY 14830-2257 - Phone
- (607) 937-8307
- NPI assigned
- Mar 13, 2022
- Last updated
- Mar 13, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 068026 | NY | Primary |
Addresses
Primary practice location
24 S Bridge St
Corning, NY 14830-2257
Mailing address
24 S Bridge St
Corning, NY 14830-2257
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 |
|---|---|---|---|
| 068026 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wegmans Food Markets, Inc. | Current | Accepting new patients | |
| Wegmans Food Markets, Inc. | Past | Accepting new patients |
Locations
24 S Bridge St
Corning, NY 14830
Phone (607) 936-0782
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, 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": "1647129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647129600000",
"number": "1083362685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 S BRIDGE ST",
"city": "CORNING",
"state": "NY",
"postal_code": "148302257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 S BRIDGE ST",
"city": "CORNING",
"state": "NY",
"postal_code": "148302257",
"telephone_number": "607-937-8307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODRICH",
"first_name": "KYLE",
"credential": "PHARMD.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-13",
"last_updated": "2022-03-13",
"certification_date": "2022-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "068026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Corning, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.