Individual provider Active NPI

Kimilia Jenae Kent, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Portland, OR
National Provider Identifier
1376085886
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
RPH-0015729 Issued in OR
Practice address
5257 NE Martin Luther King Jr Blvd
Suite 201
Portland, OR 97211-3282
Phone
(503) 676-3710
NPI assigned
Nov 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RPH-0015729 OR Primary

Addresses

Primary practice location

5257 NE Martin Luther King Jr Blvd
Suite 201
Portland, OR 97211-3282

Mailing address

5257 NE Martin Luther King Jr Blvd
Suite 201
Portland, OR 97211-3282
Phone (503) 676-3710

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
RPH-0015729ORMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1376085886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5257 NE MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972113282",
            "telephone_number": "503-676-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5257 NE MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972113282",
            "telephone_number": "503-676-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENT",
        "first_name": "KIMILIA",
        "middle_name": "JENAE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "RPH-0015729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.