Individual provider Active NPI

Mercy Atwine Kiiza

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Boston, MA
National Provider Identifier
1174246664
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PH241091 Issued in MA
Practice address
50 Lewis St Apt 406
Boston, MA 02128-2782
Phone
(857) 221-2420
NPI assigned
Sep 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PH241091 MA Primary

Addresses

Primary practice location

50 Lewis St Apt 406
Boston, MA 02128-2782

Mailing address

50 Lewis St Apt 406
Boston, MA 02128-2782
Phone (857) 221-2420

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL walgreens.com Health Information Exchange (HIE)

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

LicenseStateTypeSpecialty
PH241091MAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1174246664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEWIS ST APT 406",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021282782",
            "telephone_number": "857-221-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LEWIS ST APT 406",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021282782",
            "telephone_number": "857-221-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIIZA",
        "first_name": "MERCY",
        "middle_name": "ATWINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MA",
            "license": "PH241091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "walgreens.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "50 Lewis St Apt 406",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021282782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.