Active NPI
Kevin John Gillon, PHARMD.
- Pharmacist
- Watkins Glen, NY
National Provider Identifier
1194007575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 056093
- Practice address
- 506 S Franklin St
Watkins Glen, NY 14891-1524 - Phone
- (607) 535-7350
- NPI assigned
- Sep 13, 2011
- Last updated
- Sep 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 056093 | NY | Primary |
Addresses
Primary practice location
506 S Franklin St
Watkins Glen, NY 14891-1524
Mailing address
4817 E Lake Rd
Geneva, NY 14456-9247
Phone (315) 730-2001
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056093 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1194007575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4817 E LAKE RD",
"city": "GENEVA",
"state": "NY",
"postal_code": "144569247",
"telephone_number": "315-730-2001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 S FRANKLIN ST",
"city": "WATKINS GLEN",
"state": "NY",
"postal_code": "148911524",
"telephone_number": "607-535-7350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLON",
"first_name": "KEVIN",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "PHARMD.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-13",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "056093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watkins Glen, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.