Active NPI
Kimberly Kustron
- Pharmacist
- Cave Creek, AZ
National Provider Identifier
1154700383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S020550
- Practice address
- 28138 N Tatum Blvd
Cave Creek, AZ 85331-6303 - Phone
- (480) 620-4393
- NPI assigned
- May 20, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S020550 | AZ | Primary |
Addresses
Primary practice location
28138 N Tatum Blvd
Cave Creek, AZ 85331-6303
Mailing address
23927 N 77TH Way
Scottsdale, AZ 85255-6153
Phone (480) 563-1908
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 |
|---|---|---|---|
| S020550 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432080000000",
"number": "1154700383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23927 N 77TH WAY",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852556153",
"telephone_number": "480-563-1908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28138 N TATUM BLVD",
"city": "CAVE CREEK",
"state": "AZ",
"postal_code": "853316303",
"telephone_number": "480-620-4393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUSTRON",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-20",
"last_updated": "2015-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S020550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cave Creek, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.