Active NPI
Kristina Vizcaino, PHARMD, CACP
- Pharmacist
- Greenville, SC
National Provider Identifier
1144755539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36847
- Practice address
- 200 Patewood Dr Ste C300
Greenville, SC 29615-6324 - Phone
- (864) 454-2852
- NPI assigned
- Apr 24, 2017
- Last updated
- Oct 30, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 24981 | NC | |
| Pharmacist | 183500000X | 36847 | SC | Primary |
| Ambulatory Care Pharmacist | 1835P2201X | 36847 | SC | |
| Ambulatory Care Pharmacist | 1835P2201X | 24981 | NC |
Addresses
Primary practice location
200 Patewood Dr Ste C300
Greenville, SC 29615-6324
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8617
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
| License | State | Type | Specialty |
|---|---|---|---|
| 36847 | SC | MD | Pharmacist |
| 24981 | NC | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prisma Health University Medical Group | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Greenville, SC
- NPI 1295763217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604016000000",
"number": "1144755539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MCBEE AVE FL 4",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012842",
"telephone_number": "864-522-8617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 PATEWOOD DR STE C300",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296156324",
"telephone_number": "864-454-2852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIZCAINO",
"first_name": "KRISTINA",
"credential": "PHARMD, CACP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-24",
"last_updated": "2020-10-30",
"certification_date": "2020-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "24981",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "36847",
"primary": true
},
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "SC",
"license": "36847",
"primary": false
},
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "NC",
"license": "24981",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.