Kimberly Paige Porter, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

E-100362 Issued in MS

Practice address

329 Sunset Dr
Grenada, MS 38901-4505

Phone

(662) 226-6631

Fax

(662) 226-6650

NPI assigned

Sep 13, 2021

Sex

Female

Sole proprietor

No

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

Locations

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.

• Walgreen Co

  • Pharmacy
  • Grenada, MS
  • NPI 1972764785
  NPD
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1245909134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 SUNSET DR",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014505",
            "telephone_number": "662-226-6631",
            "fax_number": "662-226-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 SUNSET DR",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014505",
            "telephone_number": "662-226-6631",
            "fax_number": "662-226-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "KIMBERLY",
        "middle_name": "PAIGE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E-100362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shonda Jacqueline Phelon, C.F.N.P.; P.M.H.N.P
• James R Philley, DMD
• Physicians and Surgeons
• Karen W Plunkett, M.D.
• Felicia Faye Poe, D.C.
• Valiparambil Balakrishnan Praveen Kumar, M.D.
• Providence PCC of Grenada, LLC
• Purposeful Therapy Solutions
• Courtney Rae Purvis, OTR/L
• Quick Care Clinic LLC

• Pharmacist in Grenada, MS
• Providers in Grenada, MS by specialty
• Pharmacist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.