Active NPI
Kipp Allen, PHARMD
- Pharmacist
- Fort Smith, AR
National Provider Identifier
1447769385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD14209
- Practice address
- 2100 N 62ND St
Fort Smith, AR 72904-5163 - Phone
- (479) 782-0606
- NPI assigned
- Sep 22, 2017
- Sex
- Male
- Sole proprietor
- Yes
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
| License | State | Type | Specialty |
|---|---|---|---|
| PD14209 | AR | MD | Pharmacist |
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD14209 | AR | Primary |
Addresses
Primary practice location
2100 N 62ND St
Fort Smith, AR 72904-5163
Mailing address
2100 N 62ND St
Fort Smith, AR 72904-5163
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PD14209 | Other | AR | ARKANSAS STATE BOARD LICENSE NUMBER |
NPI Registry JSON
{
"created_epoch": "1506038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506038400000",
"number": "1447769385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 N 62ND ST",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729045163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 N 62ND ST",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729045163",
"telephone_number": "479-782-0606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "KIPP",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-22",
"last_updated": "2017-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "AR",
"license": "PD14209",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARKANSAS STATE BOARD LICENSE NUMBER",
"identifier": "PD14209",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.