Individual provider Active NPI

Kathleen Marie Wubbenhorst, PHARMD

  • Pharmacist
  • Bryn Mawr, PA
National Provider Identifier
1285057422
Registry record updated Sep 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP442760 Issued in PA
Practice address
130 S Bryn Mawr Ave
Ground Floor
Bryn Mawr, PA 19010-3121
Phone
(484) 337-3632
Fax
(484) 337-3680
NPI assigned
Jan 23, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP442760 PA Primary

Addresses

Primary practice location

130 S Bryn Mawr Ave
Ground Floor
Bryn Mawr, PA 19010-3121

Mailing address

130 S Bryn Mawr Ave
Ground Floor
Bryn Mawr, PA 19010-3121
Phone (484) 337-3632

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

LicenseStateTypeSpecialty
RP442760PAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410480000000",
    "number": "1285057422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S BRYN MAWR AVE",
            "address_2": "GROUND FLOOR",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "484-337-3632",
            "fax_number": "484-337-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S BRYN MAWR AVE",
            "address_2": "GROUND FLOOR",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "484-337-3632",
            "fax_number": "484-337-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUBBENHORST",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-23",
        "last_updated": "2014-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP442760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; 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.