Individual provider Active NPI

Kimberly Wong, RPH

  • Pharmacist
  • Wylie, TX
National Provider Identifier
1639817455
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
69565 Issued in TX
Practice address
921 S Westgate Way
Wylie, TX 75098-4947
Phone
(972) 740-9871
NPI assigned
May 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 69565 TX Primary

Addresses

Primary practice location

921 S Westgate Way
Wylie, TX 75098-4947

Mailing address

3021 Francesca Dr
Wylie, TX 75098-8927
Phone (972) 740-9871

Other practice location 1

3021 Francesca Dr
Wylie, TX 75098-8927
Phone (972) 740-9871

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
69565TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Albertsons LLC PastSince May 29, 2022 Accepting new patients
Albertsons LLC PastSince May 29, 2022 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1639817455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3021 FRANCESCA DR",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750988927",
            "telephone_number": "972-740-9871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 S WESTGATE WAY",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750984947",
            "telephone_number": "972-740-9871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3021 Francesca Dr",
            "address_purpose": "LOCATION",
            "city": "Wylie",
            "state": "TX",
            "postal_code": "750988927",
            "country_code": "US",
            "telephone_number": "972-740-9871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "KIMBERLY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "69565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wylie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.