Individual provider Active NPI

Kimberly Diei, PHARMD

  • Pharmacy
  • Memphis, TN
National Provider Identifier
1366213696
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
47653 Issued in TN
Practice address
5080 Stage Rd
Memphis, TN 38128-5004
Phone
(901) 382-9237
NPI assigned
Jan 15, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 47653 TN Primary

Addresses

Primary practice location

5080 Stage Rd
Memphis, TN 38128-5004

Mailing address

5080 Stage Rd
Memphis, TN 38128-5004
Phone (901) 382-9237

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
47653TNMDPharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Pharmacy CurrentSince Jan 21, 2024 Accepting new patients
Walgreen Co Pharmacy PastSince Jan 21, 2024 Accepting new patients

Locations

5080 Stage Rd
Memphis, TN 38128
Phone (901) 353-4603

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.

NPI Registry JSON

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1366213696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 STAGE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381285004",
            "telephone_number": "901-382-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5080 STAGE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381285004",
            "telephone_number": "901-382-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEI",
        "first_name": "KIMBERLY",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TN",
            "license": "47653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; 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.