Individual provider Active NPI

Kalyn Marie Hendrix, PHARMD

  • Pharmacist
  • Fort Walton Beach, FL
National Provider Identifier
1104162353
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS50021 Issued in FL
Practice address
99 Eglin Pkwy NE
Ste 36
Fort Walton Beach, FL 32548-4965
Phone
(850) 244-1226
Fax
(850) 244-8418
NPI assigned
Dec 17, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS50021 FL Primary

Addresses

Primary practice location

99 Eglin Pkwy NE
Ste 36
Fort Walton Beach, FL 32548-4965

Mailing address

99 Eglin Pkwy NE
Ste 36
Fort Walton Beach, FL 32548-4965
Phone (850) 244-1226

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
PS50021FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1104162353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 EGLIN PKWY NE",
            "address_2": "STE 36",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484965",
            "telephone_number": "850-244-1226",
            "fax_number": "850-244-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 EGLIN PKWY NE",
            "address_2": "STE 36",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484965",
            "telephone_number": "850-244-1226",
            "fax_number": "850-244-8418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRIX",
        "first_name": "KALYN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-17",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS50021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; 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.