Individual provider Active NPI

Otis Wilbur Kirksey, PHARMD

  • Pharmacist
  • Tallahassee, FL
National Provider Identifier
1659539716
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS20980 Issued in FL
Practice address
438 W Brevard St
Tallahassee, FL 32301-1004
Phone
(850) 561-2688
Fax
(850) 599-3347
NPI assigned
May 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS20980 FL Primary

Addresses

Primary practice location

438 W Brevard St
Tallahassee, FL 32301-1004

Mailing address

2259 Upland Way
Tallahassee, FL 32311-3495
Phone (850) 284-6873

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)
Enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS20980FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Chronic Disease Management and Education LLC Current Accepting new patients

Organizations & group practices 1

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": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1659539716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2259 UPLAND WAY",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323113495",
            "telephone_number": "850-284-6873",
            "fax_number": "850-224-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 W BREVARD ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323011004",
            "telephone_number": "850-561-2688",
            "fax_number": "850-599-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRKSEY",
        "first_name": "OTIS",
        "middle_name": "WILBUR",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-27",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS20980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.