Kori Jayde Rios, PHARM.D

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS64731 Issued in FL

Practice address

99 Magnolia Ave
Auburndale, FL 33823-4301

Phone

(863) 967-4451

NPI assigned

Sep 22, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kori Boucher Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1194448464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 MAGNOLIA AVE",
            "city": "AUBURNDALE",
            "state": "FL",
            "postal_code": "338234301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 MAGNOLIA AVE",
            "city": "AUBURNDALE",
            "state": "FL",
            "postal_code": "338234301",
            "telephone_number": "863-967-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIOS",
        "first_name": "KORI",
        "middle_name": "JAYDE",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS64731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KORI",
            "last_name": "BOUCHER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Auburndale, FL
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.