Active NPI
Kristyn Hodge, R.PH
- Pharmacist
- Brewerton, NY
National Provider Identifier
1285816942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 050325
- Practice address
- 9543 Brewerton Rd
Suite 1
Brewerton, NY 13029-9426 - Phone
- (315) 676-3676
- NPI assigned
- Dec 4, 2007
- Last updated
- Dec 4, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 050325 | NY | Primary |
Addresses
Primary practice location
9543 Brewerton Rd
Suite 1
Brewerton, NY 13029-9426
Mailing address
9543 Brewerton Rd
Suite 1
Brewerton, NY 13029-9426
Phone (315) 676-3676
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050325 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196726400000",
"number": "1285816942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9543 BREWERTON RD",
"address_2": "SUITE 1",
"city": "BREWERTON",
"state": "NY",
"postal_code": "130299426",
"telephone_number": "315-676-3676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9543 BREWERTON RD",
"address_2": "SUITE 1",
"city": "BREWERTON",
"state": "NY",
"postal_code": "130299426",
"telephone_number": "315-676-3676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGE",
"first_name": "KRISTYN",
"credential": "R.PH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-04",
"last_updated": "2007-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "050325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brewerton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.