Individual provider Active NPI

Booth Kristopher Harned, R.PH.

  • Pharmacist
  • Springfield, MO
National Provider Identifier
1609151018
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
043188 Issued in MO
Practice address
909 E Republic Rd
Springfield, MO 65807-6004
Phone
(417) 883-5023
NPI assigned
Oct 17, 2011
Last updated
Oct 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 043188 MO Primary

Addresses

Primary practice location

909 E Republic Rd
Springfield, MO 65807-6004

Mailing address

21400 S Briar Rd
Peculiar, MO 64078-9540
Phone (816) 305-3680

Other identifiers 1

IdentifierTypeStateIssuer
043188OtherMOMISSOURI BOARD OF PHARMACY LICENSE NUMBER

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
043188MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1609151018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21400 S BRIAR RD",
            "city": "PECULIAR",
            "state": "MO",
            "postal_code": "640789540",
            "telephone_number": "816-305-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 E REPUBLIC RD",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658076004",
            "telephone_number": "417-883-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARNED",
        "first_name": "BOOTH",
        "middle_name": "KRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "043188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI BOARD OF PHARMACY LICENSE NUMBER",
            "identifier": "043188",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.