Individual provider Active NPI

Christy Lynn Distler, PHARM.D.

  • Pharmacist
  • Overland Park, KS
National Provider Identifier
1093144016
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
1-13438 Issued in KS
Practice address
9000 Metcalf Ave
Wal-Mart Neighborhood Market #5207
Overland Park, KS 66212-1457
Phone
(913) 649-4314
Fax
(913) 649-4483
NPI assigned
Nov 12, 2013
Last updated
Nov 12, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 1-13438 KS Primary
Pharmacist 183500000X 2004020355 MO

Addresses

Primary practice location

9000 Metcalf Ave
Wal-Mart Neighborhood Market #5207
Overland Park, KS 66212-1457

Mailing address

9000 Metcalf Ave
Wal-Mart Neighborhood Market #5207
Overland Park, KS 66212-1457
Phone (913) 649-4314

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

LicenseStateTypeSpecialty
1-13438KSMDPharmacist
2004020355MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walmart Inc. Past Accepting new patients
Walmart Inc. 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, 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": "1384214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1093144016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 METCALF AVE",
            "address_2": "WAL-MART NEIGHBORHOOD MARKET #5207",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662121457",
            "telephone_number": "913-649-4314",
            "fax_number": "913-649-4483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 METCALF AVE",
            "address_2": "WAL-MART NEIGHBORHOOD MARKET #5207",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662121457",
            "telephone_number": "913-649-4314",
            "fax_number": "913-649-4483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTLER",
        "first_name": "CHRISTY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-12",
        "last_updated": "2013-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-13438",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2004020355",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; 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.