Active NPI
Kimberly Dawn Oliver, RPH
- Pharmacist
- Clendenin, WV
National Provider Identifier
1225419104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0005687
- Practice address
- 107 Koontz Ave
Clendenin, WV 25045-9578 - Phone
- (304) 548-2155
- NPI assigned
- Jun 16, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 0005687 | WV | Primary |
Addresses
Primary practice location
107 Koontz Ave
Clendenin, WV 25045-9578
Mailing address
107 Koontz Ave
Clendenin, WV 25045-9578
Phone (304) 548-2155
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 |
|---|---|---|---|
| 0005687 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434412800000",
"number": "1225419104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 KOONTZ AVE",
"city": "CLENDENIN",
"state": "WV",
"postal_code": "250459578",
"telephone_number": "304-548-2155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 KOONTZ AVE",
"city": "CLENDENIN",
"state": "WV",
"postal_code": "250459578",
"telephone_number": "304-548-2155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVER",
"first_name": "KIMBERLY",
"middle_name": "DAWN",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-16",
"last_updated": "2015-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "0005687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clendenin, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.