Individual provider Active NPI

Kenneth Cole Sizemore

  • Pharmacist
  • Carbondale, IL
National Provider Identifier
1124933320
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.309266 Issued in IL
Practice address
1450 E Main St
Carbondale, IL 62901-3140
Phone
(618) 457-2033
NPI assigned
Aug 14, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.309266 IL Primary

Addresses

Primary practice location

1450 E Main St
Carbondale, IL 62901-3140

Mailing address

13043 Talley Town St
Carterville, IL 62918-3489

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

NPI Registry JSON

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

{
    "created_epoch": "1786665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1124933320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13043 TALLEY TOWN ST",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "629183489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 E MAIN ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013140",
            "telephone_number": "618-457-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIZEMORE",
        "first_name": "KENNETH",
        "middle_name": "COLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-14",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.309266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.