Organization Active NPI

Kaiser Permanente Mas

  • Pharmacist
  • Largo, MD
National Provider Identifier
1528309366
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13942 Issued in MD
Legal business name
KAISER PERMANENTE MAS
Practice address
1221 Mercantile LN
Largo, MD 20774-5374
Phone
(240) 848-6675
Fax
(301) 618-5554
NPI assigned
Mar 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Authorized official

Name
Ms. Cruzita Kimberly Bryant, RPH
Title
Assistant Area Operations Manager
Phone
(240) 848-6675

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 183500000X 13942 MD Primary

Addresses

Primary practice location

1221 Mercantile LN
Largo, MD 20774-5374

Mailing address

11508 Gloxinia CT
Upper Marlboro, MD 20774-9219
Phone (240) 848-6675

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1528309366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11508 GLOXINIA CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207749219",
            "telephone_number": "240-848-6675",
            "fax_number": "301-618-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MERCANTILE LN",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745374",
            "telephone_number": "240-848-6675",
            "fax_number": "301-618-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER PERMANENTE MAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-04",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "CRUZITA",
        "authorized_official_middle_name": "KIMBERLY",
        "authorized_official_title_or_position": "ASSISTANT AREA OPERATIONS MANAGER",
        "authorized_official_telephone_number": "240-848-6675",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "13942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.