Active NPI
Kristin N Renzi, RPH
- Pharmacist
- Watertown, NY
National Provider Identifier
1194956037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 041419
- Practice address
- 1655 State Street
Walgreens
Watertown, NY 13601 - Phone
- (315) 785-1088
- NPI assigned
- Jul 27, 2009
- Last updated
- Jul 27, 2009
- Sex
- Female
- Sole proprietor
- No
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 | 041419 | NY | Primary |
Addresses
Primary practice location
1655 State Street
Walgreens
Watertown, NY 13601
Mailing address
1655 State Street
Watertown, NY 13601
Phone (315) 785-1088
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041419 | NY | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co. | 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": "1248652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248652800000",
"number": "1194956037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1655 STATE STREET",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "13601",
"telephone_number": "315-785-1088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1655 STATE STREET",
"address_2": "WALGREENS",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "13601",
"telephone_number": "315-785-1088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENZI",
"first_name": "KRISTIN",
"middle_name": "N",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-27",
"last_updated": "2009-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "041419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.