Active NPI
Kristen Sample, PHARMD
- Pharmacist
- Carroll, IA
National Provider Identifier
1235761594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21875
- Practice address
- 905 W US Highway 30
Carroll, IA 51401-2138 - Phone
- (712) 792-9093
- Fax
- (712) 792-7815
- NPI assigned
- Feb 5, 2020
- 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 | 21875 | IA | Primary |
Addresses
Primary practice location
905 W US Highway 30
Carroll, IA 51401-2138
Mailing address
905 W US Highway 30
Carroll, IA 51401-2138
Phone (712) 792-9093
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21875 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580860800000",
"number": "1235761594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 W US HIGHWAY 30",
"city": "CARROLL",
"state": "IA",
"postal_code": "514012138",
"telephone_number": "712-792-9093",
"fax_number": "712-792-7815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 W US HIGHWAY 30",
"city": "CARROLL",
"state": "IA",
"postal_code": "514012138",
"telephone_number": "712-792-9093",
"fax_number": "712-792-7815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPLE",
"first_name": "KRISTEN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-05",
"last_updated": "2020-02-05",
"certification_date": "2020-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "21875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carroll, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.