Individual provider Active NPI

Kevin David McClimon, RPH

  • Pharmacist
  • Bellevue, IA
National Provider Identifier
1598883894
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17396 Issued in IA
Practice address
115 State St
Bellevue, IA 52031-1307
Phone
(563) 872-4259
Fax
(563) 872-4837
NPI assigned
Mar 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17396 IA Primary

Addresses

Primary practice location

115 State St
Bellevue, IA 52031-1307

Mailing address

701 Spring St
Bellevue, IA 52031-9324
Phone (563) 872-4259

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
17396IAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598883894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 SPRING ST",
            "city": "BELLEVUE",
            "state": "IA",
            "postal_code": "520319324",
            "telephone_number": "563-872-4259",
            "fax_number": "563-872-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 STATE ST",
            "city": "BELLEVUE",
            "state": "IA",
            "postal_code": "520311307",
            "telephone_number": "563-872-4259",
            "fax_number": "563-872-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLIMON",
        "first_name": "KEVIN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "17396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.