NPIMap

Individual provider Active NPI

Kimberly S Lizardo, PHARM.D.

  • Pharmacist
  • Mount Airy, MD
National Provider Identifier
1508204819
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21242 Issued in MD
Practice address
2702 Back Acre Cir
Suite 190-B
Mount Airy, MD 21771-7769
Phone
(301) 703-8836
NPI assigned
Jun 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21242 MD Primary

Addresses

Primary practice location

2702 Back Acre Cir
Suite 190-B
Mount Airy, MD 21771-7769

Mailing address

2702 Back Acre Cir
Suite 190-B
Mount Airy, MD 21771-7769
Phone (301) 703-8836

Other names 1

  • Dr. Kimberly N Santos Former name

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
21242MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Avni Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1508204819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 BACK ACRE CIR",
            "address_2": "SUITE 190-B",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217717769",
            "telephone_number": "301-703-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 BACK ACRE CIR",
            "address_2": "SUITE 190-B",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217717769",
            "telephone_number": "301-703-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZARDO",
        "first_name": "KIMBERLY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-08",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "21242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SANTOS",
            "middle_name": "N",
            "prefix": "DR.",
            "credential": "PHARM.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Airy, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; 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.