Active NPI
Kenneth Parker III, PHARMD
- Pharmacist
- Winston Salem, NC
National Provider Identifier
1518253426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21359
- Practice address
- 10478 N NC Highway 109
Winston Salem, NC 27107-9634 - Phone
- (336) 769-0872
- Fax
- (336) 769-4826
- NPI assigned
- Jun 20, 2011
- Sex
- Male
- Sole proprietor
- No
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 | 21359 | NC | Primary |
Addresses
Primary practice location
10478 N NC Highway 109
Winston Salem, NC 27107-9634
Mailing address
4810 Bisbee Dr
Greensboro, NC 27407-9710
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients | |
| South Carolina CVS Pharmacy LLC | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308528000000",
"number": "1518253426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4810 BISBEE DR",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274079710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10478 N NC HIGHWAY 109",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271079634",
"telephone_number": "336-769-0872",
"fax_number": "336-769-4826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKER",
"first_name": "KENNETH",
"name_suffix": "III",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-20",
"last_updated": "2011-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "21359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.