Kimalyn Sue Averill, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302030463 Issued in MI

Practice address

3191 28TH St SW
Grandville, MI 49418-1110

Phone

(616) 534-5533

Fax

(616) 534-2205

NPI assigned

Aug 25, 2011

Last updated

Aug 25, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

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.

• Walgreen Co

  dba Walgreens #03012

  • Pharmacy
  • Grandville, MI
  • NPI 1528073632
  NPD (past)
• Walgreen Co

  dba Walgreens #21605

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1376823005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2281 BRIDLE CREEK ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495080957",
            "telephone_number": "616-745-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3191 28TH ST SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181110",
            "telephone_number": "616-534-5533",
            "fax_number": "616-534-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERILL",
        "first_name": "KIMALYN",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-25",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302030463",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS42372",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aspen Dental of Michigan PC
• Athletico LTD (Athletico Physical Therapy)
• Whitney Atkinson
• Ann M Auburn, D.O.
• Michelle Katherine Aue, PA-C
• Mary D Ayers, MA, LLC
• Neidaly Babcock
• Margaret Elizabeth Bader, FNP
• Yeimi Cecilia Baez Gil
• Autumn N Bahlke, LMT

• Pharmacist in Grandville, MI
• Providers in Grandville, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; 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.