Individual provider Active NPI

Greg Kimmel, RPH

  • Ambulatory Care Pharmacist
  • Perrysburg, OH
National Provider Identifier
1447925961
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
03213821 Issued in OH
Practice address
12623 Eckel Junction Rd
Perrysburg, OH 43551-1304
Phone
(567) 368-1434
Fax
(567) 368-1433
NPI assigned
Aug 16, 2021
Last updated
Aug 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X 03213821 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) 368-1434

Other identifiers 1

IdentifierTypeStateIssuer
0329364MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address greg_kimmel1@mercy.com Direct

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
03213821OHMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1447925961",
    "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": "567-368-1434",
            "fax_number": "567-368-1433"
        },
        {
            "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": "567-368-1434",
            "fax_number": "567-368-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMEL",
        "first_name": "GREG",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "OH",
            "license": "03213821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0329364",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "greg_kimmel1@mercy.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12623 Eckel Junction Rd",
            "city": "Perrysburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "435511304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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, 2021; 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.