Active NPI
Kristy Buckholtz
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Tipp City, OH
National Provider Identifier
1164025987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 03227876
- Practice address
- 914 W Main St
Tipp City, OH 45371-1337 - Phone
- (937) 667-8428
- NPI assigned
- Nov 17, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 03227876 | OH | Primary |
Addresses
Primary practice location
914 W Main St
Tipp City, OH 45371-1337
Mailing address
3071 Cattail Dr
Tipp City, OH 45371-8379
Phone (937) 506-7062
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 |
|---|---|---|---|
| 03227876 | OH | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1164025987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3071 CATTAIL DR",
"city": "TIPP CITY",
"state": "OH",
"postal_code": "453718379",
"telephone_number": "937-506-7062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "914 W MAIN ST",
"city": "TIPP CITY",
"state": "OH",
"postal_code": "453711337",
"telephone_number": "937-667-8428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKHOLTZ",
"first_name": "KRISTY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-17",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "OH",
"license": "03227876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tipp City, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.