Active NPI
Kenneth Wimbish
- Pharmacist
- Amite, LA
National Provider Identifier
1114338639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 017030
- Practice address
- 1200 W Oak St
Amite, LA 70422-2762 - Phone
- (985) 748-7731
- Fax
- (985) 740-7731
- NPI assigned
- May 19, 2014
- 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 | 017030 | LA | Primary |
Addresses
Primary practice location
1200 W Oak St
Amite, LA 70422-2762
Mailing address
37310 Highway 10
Franklinton, LA 70438-3297
Phone (985) 974-5029
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
| License | State | Type | Specialty |
|---|---|---|---|
| 017030 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400457600000",
"number": "1114338639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37310 HIGHWAY 10",
"city": "FRANKLINTON",
"state": "LA",
"postal_code": "704383297",
"telephone_number": "985-974-5029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W OAK ST",
"city": "AMITE",
"state": "LA",
"postal_code": "704222762",
"telephone_number": "985-748-7731",
"fax_number": "985-740-7731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIMBISH",
"first_name": "KENNETH",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-19",
"last_updated": "2014-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "017030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amite, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.