Active NPI
Kerrie Wilson, PHARMD
- Pharmacist
- Orange Beach, AL
National Provider Identifier
1659974160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17034
- Practice address
- 25761 Perdido Beach Blvd
Orange Beach, AL 36561-6107 - Phone
- (251) 974-1590
- Fax
- (251) 974-1595
- NPI assigned
- Nov 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 17034 | AL | Primary |
Addresses
Primary practice location
25761 Perdido Beach Blvd
Orange Beach, AL 36561-6107
Mailing address
25761 Perdido Beach Blvd
Orange Beach, AL 36561-6107
Phone (251) 974-1590
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17034 | Medicaid | AL |
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17034 | AL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alabama CVS Pharmacy, L.L.C. | Current | Accepting new patients | |
| Alabama CVS Pharmacy LLC | Past | Accepting new patients |
Locations
25761 Perdido Beach Blvd
Orange Beach, AL 36561
Phone (251) 974-1590
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": "1605571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1659974160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25761 PERDIDO BEACH BLVD",
"city": "ORANGE BEACH",
"state": "AL",
"postal_code": "365616107",
"telephone_number": "251-974-1590",
"fax_number": "251-974-1595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25761 PERDIDO BEACH BLVD",
"city": "ORANGE BEACH",
"state": "AL",
"postal_code": "365616107",
"telephone_number": "251-974-1590",
"fax_number": "251-974-1595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KERRIE",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-17",
"last_updated": "2020-11-17",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "17034",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "17034",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orange Beach, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.