NPIMap

Individual provider Active NPI

Kenneth Ryan Pugh

  • Pharmacist
  • Prestonsburg, KY
National Provider Identifier
1255936001
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
018559 Issued in KY
Practice address
429 University Dr
Prestonsburg, KY 41653-1071
Phone
(606) 889-9572
NPI assigned
Dec 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 018559 KY Primary

Addresses

Primary practice location

429 University Dr
Prestonsburg, KY 41653-1071

Mailing address

429 University Dr
Prestonsburg, KY 41653-1071
Phone (606) 889-9572

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

State licenses

LicenseStateTypeSpecialty
018559KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
K-VA-T Food Stores Inc PastSince Dec 6, 2020 Accepting new patients
K VA T Food Stores Inc PastSince Dec 6, 2020 Accepting new patients

Organizations & group practices 2

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": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1255936001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 UNIVERSITY DR",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531071",
            "telephone_number": "606-889-9572",
            "fax_number": "606-889-6546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 UNIVERSITY DR",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531071",
            "telephone_number": "606-889-9572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGH",
        "first_name": "KENNETH",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "018559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prestonsburg, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.