Active NPI
Kenneth Roberts Hatley, RPH
- Pharmacist
- Dallas, TX
National Provider Identifier
1316274210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 29055
- Practice address
- 7586 Mountain Creek Pkwy
Dallas, TX 75249-1356 - Phone
- (972) 572-2423
- Fax
- (972) 572-2428
- NPI assigned
- Nov 13, 2009
- Sex
- Male
- 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 | 29055 | TX | Primary |
Addresses
Primary practice location
7586 Mountain Creek Pkwy
Dallas, TX 75249-1356
Mailing address
1542 N Cedar Hill Rd
Cedar Hill, TX 75104-5206
Phone (972) 780-8277
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 |
|---|---|---|---|
| 29055 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
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": "1258070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258070400000",
"number": "1316274210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1542 N CEDAR HILL RD",
"city": "CEDAR HILL",
"state": "TX",
"postal_code": "751045206",
"telephone_number": "972-780-8277",
"fax_number": "972-780-8277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7586 MOUNTAIN CREEK PKWY",
"city": "DALLAS",
"state": "TX",
"postal_code": "752491356",
"telephone_number": "972-572-2423",
"fax_number": "972-572-2428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATLEY",
"first_name": "KENNETH",
"middle_name": "ROBERTS",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-11-13",
"last_updated": "2009-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "29055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.