Individual provider Active NPI

Kathryn Kleckner, PHARMD

  • Pharmacist
  • Perrysburg, OH
National Provider Identifier
1417730193
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03325459 Issued in OH
Practice address
12623 Eckel Junction Rd
Perrysburg, OH 43551-1304
Phone
(567) 368-1507
NPI assigned
Aug 16, 2023
Last updated
Aug 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03325459 OH Primary

Addresses

Primary practice location

12623 Eckel Junction Rd
Perrysburg, OH 43551-1304

Mailing address

12623 Eckel Junction Rd
Perrysburg, OH 43551-1304
Phone (567) 368-1507

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
03325459OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1417730193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12623 ECKEL JUNCTION RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511304",
            "telephone_number": "567-368-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12623 ECKEL JUNCTION RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511304",
            "telephone_number": "567-368-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLECKNER",
        "first_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03325459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.