Kris Denzel Tupas, PHARMD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

611 E Douglas Rd Ste 407
Mishawaka, IN 46545-1468

Phone

(574) 335-6500

Fax

(574) 335-0771

NPI assigned

Jun 15, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497484800000",
    "number": "1629508254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E CEDAR ST",
            "address_2": "SUITE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172057",
            "telephone_number": "574-335-8700",
            "fax_number": "574-335-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD STE 407",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451468",
            "telephone_number": "574-335-6500",
            "fax_number": "574-335-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUPAS",
        "first_name": "KRIS",
        "middle_name": "DENZEL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2017-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PENDING",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Student in an Organized Health Care Education/Training Program in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; 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.