Active NPI
Kimberly Destino
- Pharmacist
- North Tonawanda, NY
National Provider Identifier
1508991381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 33334
- Practice address
- 525 Division St
North Tonawanda, NY 14120-4403 - Phone
- (716) 694-3138
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 33334 | NY | Primary |
Addresses
Primary practice location
525 Division St
North Tonawanda, NY 14120-4403
Mailing address
6989 Samantha CT
Niagara Falls, NY 14304-3019
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33334 | Other | NY | LISCENSE NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33334 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Drug Shoppe, Inc. | Past | Accepting new patients | |
| The Drug Shoppe, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pharmacy
- Buffalo, NY
- NPI 1295885010
-
- Community/Retail Pharmacy
- North Tonawanda, NY
- NPI 1508916305
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508991381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6989 SAMANTHA CT",
"city": "NIAGARA FALLS",
"state": "NY",
"postal_code": "143043019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 DIVISION ST",
"city": "NORTH TONAWANDA",
"state": "NY",
"postal_code": "141204403",
"telephone_number": "716-694-3138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESTINO",
"first_name": "KIMBERLY",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "33334",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LISCENSE NUMBER",
"identifier": "33334",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Tonawanda, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.