Individual provider Active NPI

Kyle Anderson, PHARMD

  • Pharmacist
  • Iowa City, IA
National Provider Identifier
1417580945
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21921 Issued in IA
Practice address
812 S 1St Ave
Iowa City, IA 52245-5208
Phone
(319) 337-4279
Fax
(319) 337-6286
NPI assigned
Feb 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21921 IA Primary

Addresses

Primary practice location

812 S 1St Ave
Iowa City, IA 52245-5208

Mailing address

812 S 1St Ave
Iowa City, IA 52245-5208
Phone (319) 337-4279

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
21921IAMDPharmacist

Interoperability endpoints

  • Direct secure messaging: kanderson59344@uihcdirect.org

NPI Registry JSON

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1417580945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 S 1ST AVE",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522455208",
            "telephone_number": "319-337-4279",
            "fax_number": "319-337-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 S 1ST AVE",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522455208",
            "telephone_number": "319-337-4279",
            "fax_number": "319-337-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KYLE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-12",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "21921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; 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.