Active NPI
Kimberly Lyn Green, RPH
- Pharmacist
- Rusk, TX
National Provider Identifier
1568389484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 32167
- Practice address
- 805 N Dickinson Dr
Rusk, TX 75785-1006 - Phone
- (903) 683-7092
- NPI assigned
- Jul 1, 2026
- Last updated
- Jul 1, 2026
- Sex
- Female
- 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 | 32167 | TX | Primary |
Addresses
Primary practice location
805 N Dickinson Dr
Rusk, TX 75785-1006
Mailing address
805 N Dickinson Dr
Rusk, TX 75785-1006
Phone (903) 683-7092
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32167 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782864000000",
"number": "1568389484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 N DICKINSON DR",
"city": "RUSK",
"state": "TX",
"postal_code": "757851006",
"telephone_number": "903-683-7092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 N DICKINSON DR",
"city": "RUSK",
"state": "TX",
"postal_code": "757851006",
"telephone_number": "903-683-7092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "KIMBERLY",
"middle_name": "LYN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-07-01",
"last_updated": "2026-07-01",
"certification_date": "2026-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "32167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rusk, TX
- Vashti Jude Forbes, FNP-C
- Brittany Ford
- Cristal Garner, MSN, APRN, PMHNP-BC
- Paul Andrew Germany
- Carol Grady
- Rick Hale
- Larry R Hawkins, MD
- Health and Human Services Commission (Rusk State Hospital Pharmacy)
- Health and Human Services Commission (Rusk State Hospital)
- Health and Human Services Commission (Rusk State Hospital)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.