Individual provider Active NPI

Averille Kinley, RPH

  • Pharmacist
  • Denton, NC
National Provider Identifier
1386923076
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14019 Issued in NC
Practice address
310 Vernon Ave
Denton, NC 27239-8913
Phone
(336) 859-4572
Fax
(336) 859-0418
NPI assigned
Aug 11, 2011
Last updated
Aug 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 14019 NC Primary

Addresses

Primary practice location

310 Vernon Ave
Denton, NC 27239-8913

Mailing address

310 Vernon Ave
Denton, NC 27239-8913

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

LicenseStateTypeSpecialty
14019NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1386923076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 VERNON AVE",
            "city": "DENTON",
            "state": "NC",
            "postal_code": "272398913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 VERNON AVE",
            "city": "DENTON",
            "state": "NC",
            "postal_code": "272398913",
            "telephone_number": "336-859-4572",
            "fax_number": "336-859-0418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINLEY",
        "first_name": "AVERILLE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "14019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.