Individual provider Active NPI

Stacey Akemi Kwan, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • North Kansas City, MO
National Provider Identifier
1174879043
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
045238 Issued in MO
Practice address
2800 Clay Edwards Dr
North Kansas City, MO 64116-3220
Phone
(816) 691-5215
NPI assigned
Jul 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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 045238 MO Primary

Addresses

Primary practice location

2800 Clay Edwards Dr
North Kansas City, MO 64116-3220

Mailing address

431 Kings RDG
Liberty, MO 64068-1110
Phone (816) 407-1550

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

LicenseStateTypeSpecialty
045238MOMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1174879043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 KINGS RDG",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681110",
            "telephone_number": "816-407-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CLAY EDWARDS DR",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163220",
            "telephone_number": "816-691-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAN",
        "first_name": "STACEY",
        "middle_name": "AKEMI",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MO",
            "license": "045238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; 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.