Active NPI
Kimberly K Jones, RPH.
- Pharmacist
- Williamsburg, KY
National Provider Identifier
1104992007
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(4) exclusion effective May 20, 2020.
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 009743
- Practice address
- 865 S Highway 25 W
Williamsburg, KY 40769-1918 - Phone
- (606) 549-8700
- Fax
- (606) 549-9555
- NPI assigned
- Nov 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 009743 | KY | Primary |
Addresses
Primary practice location
865 S Highway 25 W
Williamsburg, KY 40769-1918
Mailing address
865 S Highway 25 W
Williamsburg, KY 40769-1918
Phone (606) 549-8700
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009743 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kims Hometown Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Williamsburg, KY
- NPI 1376700138
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244764800000",
"number": "1104992007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "865 S HIGHWAY 25 W",
"city": "WILLIAMSBURG",
"state": "KY",
"postal_code": "407691918",
"telephone_number": "606-549-8700",
"fax_number": "606-549-9555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "865 S HIGHWAY 25 W",
"city": "WILLIAMSBURG",
"state": "KY",
"postal_code": "407691918",
"telephone_number": "606-549-8700",
"fax_number": "606-549-9555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "KIMBERLY",
"middle_name": "K",
"credential": "RPH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-24",
"last_updated": "2009-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "009743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Williamsburg, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.