Kroger Limited Partnership I

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

C1768 Issued in TN

Legal business name

KROGER LIMITED PARTNERSHIP I

Practice address

2130 Exeter Rd
Germantown, TN 38138-3922

Phone

(901) 754-7864

Fax

(901) 758-3632

NPI assigned

Jul 10, 2006

Organization subpart

No

Name

Karla Langworthy

Title

Manager of Pharmacy Credentialing

Phone

(513) 698-1878

Organizations this organization is a member of, according to the National Provider Directory.

• The Kroger Co

  • Community/Retail Pharmacy
  • Woodstock, GA
  • NPI 1720012560

  Member Of

  NPD member

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Victoria Apple, PHARM. D.

  • Pharmacist
  • Germantown, TN
  • NPI 1104160282
  NPD (past)
• Cristi Johnson Harding

  • Pharmacist
  • Germantown, TN
  • NPI 1033453113
  NPD (past)
• Lindsey Henson, PHARM. D.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Atoka, TN
  • NPI 1457647000
  NPD (past)
• Alicia G Sims, PHARM D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Olive Branch, MS
  • NPI 1821398025
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

• KROGER PHARMACY Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 7, 2014.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396828800000",
    "number": "1366476095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 RIDGE LAKE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209427",
            "telephone_number": "901-765-4157",
            "fax_number": "901-765-4213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 EXETER RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383922",
            "telephone_number": "901-754-7864",
            "fax_number": "901-758-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KROGER LIMITED PARTNERSHIP I",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2014-04-07",
        "status": "A",
        "authorized_official_last_name": "LANGWORTHY",
        "authorized_official_first_name": "KARLA",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY CREDENTIALING",
        "authorized_official_telephone_number": "513-698-1878"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "C1768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2090105",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9449318",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KROGER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David H. Kraus, MD
• Gordon Jerome Kraus, MD
• Robert Mark Kraus, MD
• Sydney Brooke Kreisman, FNP-C
• Kristina Murphy FNP, LLC
• Robert Paul Krumhansl, PT
• Jennifer Kundeti
• William Kurts, P.T.,D.P.T.,O.C.S
• Patrick Wayne Kutas, DDS
• Sarah Kutas, DDS

• All providers in Germantown, TN
• Community/Retail Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.