Individual provider Active NPI

Kimberly Ann Reno-Ly, PHARMD

  • Pharmacotherapy Pharmacist
  • Orlando, FL
National Provider Identifier
1184631806
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
25867 Issued in MA
Practice address
13800 Veterans Way
Orlando, FL 32827
Phone
(407) 631-0119
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 25867 MA Primary

Addresses

Primary practice location

13800 Veterans Way
Orlando, FL 32827

Mailing address

10244 Malpas PT
Orlando, FL 32832-6158

Other practice location 1

830 Chalkstone Ave
Providence, RI 02908-4734
Phone (401) 273-7100

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
25867MAMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1184631806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10244 MALPAS PT",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328326158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 VETERANS WAY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32827",
            "telephone_number": "407-631-0119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Chalkstone Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029084734",
            "country_code": "US",
            "telephone_number": "401-273-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENO-LY",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MA",
            "license": "25867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.