Individual provider Active NPI

Kevin D Boggs, RPH

  • Pharmacist
  • Midland, TX
National Provider Identifier
1588979256
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
33134 Issued in TX
Practice address
3325 W Wadley Ave
Midland, TX 79707-5714
Phone
(432) 697-1484
Fax
(432) 697-1489
NPI assigned
Aug 18, 2010
Last updated
Aug 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 33134 TX Primary

Addresses

Primary practice location

3325 W Wadley Ave
Midland, TX 79707-5714

Mailing address

3325 W Wadley Ave
Midland, TX 79707-5714
Phone (432) 697-1484

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

LicenseStateTypeSpecialty
33134TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
H-E-B, LP Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1282089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1588979256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 W WADLEY AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797075714",
            "telephone_number": "432-697-1484",
            "fax_number": "432-697-1489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 W WADLEY AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797075714",
            "telephone_number": "432-697-1484",
            "fax_number": "432-697-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "KEVIN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-18",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "33134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.