Active NPI
Kevin Berry
- Pharmacist
- Roswell, NM
National Provider Identifier
1134829245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP00009855
- Practice address
- 1110 S Main St
Roswell, NM 88203-5635 - Phone
- (575) 623-9300
- NPI assigned
- Mar 7, 2023
- 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 | RP00009855 | NM | Primary |
Addresses
Primary practice location
1110 S Main St
Roswell, NM 88203-5635
Mailing address
7715 Santa Maria CT NW
Albuquerque, NM 87120-3607
Phone (505) 288-9410
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 |
|---|---|---|---|
| RP00009855 | NM | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1134829245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7715 SANTA MARIA CT NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871203607",
"telephone_number": "505-288-9410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1110 S MAIN ST",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882035635",
"telephone_number": "575-623-9300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERRY",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-07",
"last_updated": "2023-03-07",
"certification_date": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "RP00009855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.