Active NPI
Katelin Meredith Lisenby, PHARM.D.
- Pharmacist
- Gordo, AL
National Provider Identifier
1194132944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17392
- Practice address
- 27340 Highway 86
Gordo, AL 35466-3578 - Phone
- (205) 364-7135
- NPI assigned
- Jul 14, 2014
- Last updated
- Nov 16, 2015
- Sex
- Female
- 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 | 17392 | AL | Primary |
Addresses
Primary practice location
27340 Highway 86
Gordo, AL 35466-3578
Mailing address
850 5TH Ave E
Box #870374
Tuscaloosa, AL 35401-7419
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 |
|---|---|---|---|
| 17392 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447632000000",
"number": "1194132944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 5TH AVE E",
"address_2": "BOX #870374",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354017419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27340 HIGHWAY 86",
"city": "GORDO",
"state": "AL",
"postal_code": "354663578",
"telephone_number": "205-364-7135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISENBY",
"first_name": "KATELIN",
"middle_name": "MEREDITH",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-14",
"last_updated": "2015-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "17392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gordo, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.