Kristyn Michele Funderburke, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

35747 Issued in SC

Practice address

1905 E Main St
Spartanburg, SC 29307-2308

Phone

(864) 253-1820

NPI assigned

Aug 23, 2014

Last updated

Aug 23, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1408752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408752000000",
    "number": "1538569884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 W MOUNTAIN ST",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280862713",
            "telephone_number": "704-473-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 E MAIN ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293072308",
            "telephone_number": "864-253-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNDERBURKE",
        "first_name": "KRISTYN",
        "middle_name": "MICHELE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-23",
        "last_updated": "2014-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "24532",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "35747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Matthew Fuller, MD
• Mimi O Fuller, CNA
• Eric S Fulmer, MD
• James Sidney Fulmer Sr., M.D.
• Sara Elizabeth Fulton, M.S., CCC-SLP
• Dorotea M Gabel, M.D.
• Holden Matthew Gabriel, PA-C
• Maria Fernanda Gacha, MD
• Samuel A Gacha, M.D.
• Latrice Gaffney, RN

• Pharmacist in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Pharmacist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2014; 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.