Individual provider Active NPI

Kaitlin Bates, PHARMD

  • Pharmacist
  • North Little Rock, AR
National Provider Identifier
1114565959
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PD13657 Issued in AR
Practice address
2509 McCain Blvd
North Little Rock, AR 72116-7606
Phone
(501) 758-9307
NPI assigned
Dec 11, 2019
Last updated
Dec 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD13657 AR Primary
Ambulatory Care Pharmacist 1835P2201X PD13657 AR

Addresses

Primary practice location

2509 McCain Blvd
North Little Rock, AR 72116-7606

Mailing address

2509 McCain Blvd
North Little Rock, AR 72116-7606

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kaitlin.bates@stores.kroger.com

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
PD13657ARMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I PastSince Dec 15, 2019 Accepting new patients
Kroger Limited Partnership I PastSince Dec 15, 2019 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": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1114565959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 MCCAIN BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721167606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 MCCAIN BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721167606",
            "telephone_number": "501-758-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "KAITLIN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD13657",
            "primary": true
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "AR",
            "license": "PD13657",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kaitlin.bates@stores.kroger.com",
            "affiliation": "N",
            "address_1": "2509 McCain Blvd",
            "city": "North Little Rock",
            "state": "AR",
            "country_code": "US",
            "postal_code": "721167606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.