Keaton Lloyd Prebble, PHARMACY INTERN

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

I14688 Issued in KY

Practice address

4101 Tates Creek Centre Dr Ste 156
Lexington, KY 40517-3096

Phone

(859) 273-0222

NPI assigned

Apr 27, 2022

Last updated

Apr 27, 2022By the provider in NPPES

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

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1346984051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 TATES CREEK CENTRE DR STE 156",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405173096",
            "telephone_number": "859-273-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TATES CREEK CENTRE DR STE 156",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405173096",
            "telephone_number": "859-273-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREBBLE",
        "first_name": "KEATON",
        "middle_name": "LLOYD",
        "credential": "PHARMACY INTERN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "I14688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Paige Pratt, PA
• Jeffery Pratt Jr., PSY.D.
• Jing-Jing Zhang Pratt, DMD
• Margaret G Pratt
• Praxair Healthcare Services, Inc.
• Precision Fit Medical
• Preferred Case Management, LLC
• Preferred Injury Physicians LLC
• Premier Clinical Laboratory LLC
• Premier Pediatrics, PLLC

• Community/Retail Pharmacy in Lexington, KY
• Providers in Lexington, KY by specialty
• Community/Retail Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.