Individual provider Active NPI

Kristen Ann McKibban

  • Pharmacist
  • West Des Moines, IA
National Provider Identifier
1487296562
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20280 Issued in IA
Practice address
1001 Office Park Rd Ste 216
West Des Moines, IA 50265-2509
Phone
(515) 419-5988
NPI assigned
Oct 10, 2019
Last updated
Oct 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20280 IA Primary

Addresses

Primary practice location

1001 Office Park Rd Ste 216
West Des Moines, IA 50265-2509

Mailing address

6609 Peckham St
Johnston, IA 50131-2856
Phone (515) 419-5988

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

NPI Registry JSON

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1487296562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6609 PECKHAM ST",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312856",
            "telephone_number": "515-419-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 OFFICE PARK RD STE 216",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502652509",
            "telephone_number": "515-419-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIBBAN",
        "first_name": "KRISTEN",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "20280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.