Active NPI
Fred Hill, RPH
- Pharmacist
- Berea, KY
National Provider Identifier
1639106123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12079
- Practice address
- 104 Legacy Dr
Berea, KY 40403-9594 - Phone
- (859) 986-2323
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- 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 | 12079 | KY | Primary |
Addresses
Primary practice location
104 Legacy Dr
Berea, KY 40403-9594
Mailing address
605 Apricot Dr
Richmond, KY 40475-8684
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12079 | Other | KY | STATE 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
| License | State | Type | Specialty |
|---|---|---|---|
| 12079 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639106123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 APRICOT DR",
"city": "RICHMOND",
"state": "KY",
"postal_code": "404758684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 LEGACY DR",
"city": "BEREA",
"state": "KY",
"postal_code": "404039594",
"telephone_number": "859-986-2323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILL",
"first_name": "FRED",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "12079",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "12079",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Berea, KY
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.