Individual provider Active NPI

Kelly C Byun, RPH

  • Pharmacist
  • Dix Hills, NY
National Provider Identifier
1194972935
Registry record updated Aug 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
040316 Issued in NY
Practice address
16 Winter LN
Dix Hills, NY 11746-5727
Phone
(718) 380-3330
Fax
(718) 380-4401
NPI assigned
Aug 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 040316 NY Primary

Addresses

Primary practice location

16 Winter LN
Dix Hills, NY 11746-5727

Mailing address

16 Winter LN
Dix Hills, NY 11746-5727
Phone (718) 380-3330

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

LicenseStateTypeSpecialty
040316NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1219449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219449600000",
    "number": "1194972935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WINTER LN",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465727",
            "telephone_number": "718-380-3330",
            "fax_number": "718-380-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WINTER LN",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117465727",
            "telephone_number": "718-380-3330",
            "fax_number": "718-380-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYUN",
        "first_name": "KELLY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-23",
        "last_updated": "2008-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "040316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dix Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2008; 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.