Active NPI
Susan Mary Kile, RPH
- Pharmacist
- Ballston Spa, NY
National Provider Identifier
1366765208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36367
- Practice address
- 4 Front St
Ballston Spa, NY 12020-1778 - Phone
- (518) 885-7330
- Fax
- (518) 885-7460
- NPI assigned
- Mar 7, 2010
- Last updated
- Mar 7, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 36367 | NY | Primary |
| Pharmacist | 183500000X | 2333 | VT |
Addresses
Primary practice location
4 Front St
Ballston Spa, NY 12020-1778
Mailing address
4 Front St
Ballston Spa, NY 12020-1778
Phone (518) 885-7330
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 |
|---|---|---|---|
| 36367 | NY | MD | Pharmacist |
| 2333 | VT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James R Obrien Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267920000000",
"number": "1366765208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 FRONT ST",
"city": "BALLSTON SPA",
"state": "NY",
"postal_code": "120201778",
"telephone_number": "518-885-7330",
"fax_number": "518-885-7460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 FRONT ST",
"city": "BALLSTON SPA",
"state": "NY",
"postal_code": "120201778",
"telephone_number": "518-885-7330",
"fax_number": "518-885-7460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILE",
"first_name": "SUSAN",
"middle_name": "MARY",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-07",
"last_updated": "2010-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "36367",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VT",
"license": "2333",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ballston Spa, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.