NPIMap

Organization Active NPI

Kinne Family Pharmacy Inc

Doing business as Clinic Pharmacy

  • Community/Retail Pharmacy
  • Boone, IA
National Provider Identifier
1194816546
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1474 Issued in IA
Legal business name
KINNE FAMILY PHARMACY INC
Doing business as
Clinic Pharmacy
Practice address
1115 S Marshall St
Boone, IA 50036-5304
Phone
(515) 432-7123
Fax
(515) 432-7088
NPI assigned
Sep 28, 2006
Last updated
Apr 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Authorized official

Name
Wendy Ann Kinne, PHARMDNPI 1609920602
Title
Pharmacist Owner
Phone
(515) 432-3460

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 1474 IA Primary

Addresses

Primary practice location

1115 S Marshall St
Boone, IA 50036-5304

Mailing address

1115 S Marshall St
Boone, IA 50036-5304
Phone (515) 432-7123

Other identifiers 2

IdentifierTypeStateIssuer
2142370OtherPK
1194816546MedicaidIA

Other names 1

  • Clinic Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kinne Family Pharmacy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1194816546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 S MARSHALL ST",
            "city": "BOONE",
            "state": "IA",
            "postal_code": "500365304",
            "telephone_number": "515-432-7123",
            "fax_number": "515-432-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S MARSHALL ST",
            "city": "BOONE",
            "state": "IA",
            "postal_code": "500365304",
            "telephone_number": "515-432-7123",
            "fax_number": "515-432-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINNE FAMILY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "KINNE",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PHARMACIST OWNER",
        "authorized_official_telephone_number": "515-432-3460",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "1474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142370",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194816546",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boone, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; 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.