Kyle Russell Smith

Primary specialty

PharmacistTaxonomy code 183500000X

License

79939 Issued in CA

Practice address

2006 W Avenue J
Lancaster, CA 93536-5913

Phone

(661) 945-2729

NPI assigned

Jan 9, 2020

Sex

Male

Sole proprietor

Yes

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

State licenses

Practice roles

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.

• Garfield Beach CVS LLC

  • Pharmacy
  • Lancaster, CA
  • NPI 1497790307
  NPD (past)
• Garfield Beach CVS, L.L.C.

  • Pharmacy
  • Jurupa Valley, CA
  • NPI 1780573113
  NPD (past)

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1265072086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 W AVENUE J",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935365913",
            "telephone_number": "661-945-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 W AVENUE J",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935365913",
            "telephone_number": "661-945-2729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KYLE",
        "middle_name": "RUSSELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-09",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "79939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Jaye Smith
• Demetria Loring Smith, LVN
• Jennifer M Smith
• Katrina Smith
• Kayla Michelle Smith, RADT
• La Jannelle Smith, M.S., SLP-CCC
• Michelle Lee Smith
• Michilene Shanese Smith
• Nikole Breanne Smith, RDH
• Roshawn Chalisse Smith

• Pharmacist in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.