Active NPI
Kaylin Thevis, PHARM.D
- Pharmacist
- Broussard, LA
National Provider Identifier
1285180968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 021691
- Practice address
- 120 Park Center Dr
Broussard, LA 70518-3605 - Phone
- (337) 330-2589
- Fax
- (337) 252-1100
- NPI assigned
- Aug 31, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 021691 | LA | Primary |
Addresses
Primary practice location
120 Park Center Dr
Broussard, LA 70518-3605
Mailing address
120 Park Center Dr
Broussard, LA 70518-3605
Phone (337) 330-2589
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 |
|---|---|---|---|
| 021691 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Louisiana CVS Pharmacy LLC | Past | Accepting new patients | |
| Louisiana CVS Pharmacy, L.L.C. | Past | 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.
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- Pharmacy
- Lafayette, LA
- NPI 1881737476
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617235200000",
"number": "1285180968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 PARK CENTER DR",
"city": "BROUSSARD",
"state": "LA",
"postal_code": "705183605",
"telephone_number": "337-330-2589",
"fax_number": "337-252-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 PARK CENTER DR",
"city": "BROUSSARD",
"state": "LA",
"postal_code": "705183605",
"telephone_number": "337-330-2589",
"fax_number": "337-252-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEVIS",
"first_name": "KAYLIN",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-31",
"last_updated": "2021-04-01",
"certification_date": "2021-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "021691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broussard, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.