Individual provider Active NPI

Kimberley Porter, RPH

  • Ambulatory Care Pharmacist
  • Charleston, SC
National Provider Identifier
1225580947
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
9471 Issued in SC
Practice address
135 Rutledge Ave
Room 106
Charleston, SC 29425-8903
Phone
(843) 876-0199
NPI assigned
Oct 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X 9471 SC Primary

Addresses

Primary practice location

135 Rutledge Ave
Room 106
Charleston, SC 29425-8903

Mailing address

135 Rutledge Ave
Room 106
Charleston, SC 29425-8903
Phone (843) 876-0199

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
9471SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical University Hospital Authority Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1225580947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 RUTLEDGE AVE",
            "address_2": "ROOM 106",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258903",
            "telephone_number": "843-876-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 RUTLEDGE AVE",
            "address_2": "ROOM 106",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258903",
            "telephone_number": "843-876-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "KIMBERLEY",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-28",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "SC",
            "license": "9471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.