Kenneth Lee Fears II, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

0202211042 Issued in VA

Practice address

1020 Bill Tuck Hwy Ste 1000
South Boston, VA 24592-7159

Phone

(434) 575-0078

Fax

(434) 575-0252

NPI assigned

Dec 18, 2020

Last updated

Dec 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Food Lion, LLC

  dba Food Lion Pharmacy #0542

  • Community/Retail Pharmacy
  • South Boston, VA
  • NPI 1649578972
  NPD (past)
• Food Lion, LLC

  dba Food Lion Pharmacy

  • Community/Retail Pharmacy
  • Elizabeth City, NC
  • NPI 1609371921
  NPD (past)

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1205422748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 BILL TUCK HWY STE 1000",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245927159",
            "telephone_number": "434-575-0078",
            "fax_number": "434-575-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 BILL TUCK HWY STE 1000",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245927159",
            "telephone_number": "434-575-0078",
            "fax_number": "434-575-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEARS",
        "first_name": "KENNETH",
        "middle_name": "LEE",
        "name_suffix": "II",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202211042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward S Purvis II MD PC
• Emergicare of South Boston VA Inc
• Emerging Minds Community Services LLC
• Family and Children Enrichment Services Inc.
• Family Preservation Services, Inc
• Cynthia Powell Felton, N.P.
• Dorothy A. Fensterer, D.C.
• Tammy J Ferrell
• Mara Olivia Fiorio, RDN
• First Line Med Trans Inc

• Pharmacist in South Boston, VA
• Providers in South Boston, VA by specialty
• Pharmacist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.