Individual provider Active NPI

Kimberly Ann Sukalich, PHARMD

  • Pharmacist
  • Columbus, OH
National Provider Identifier
1689108045
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03127515 Issued in OH
Practice address
1250 Dearborn Dr
Columbus, OH 43085-4767
Phone
(614) 840-3571
Fax
(866) 690-8967
NPI assigned
Apr 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03127515 OH Primary

Addresses

Primary practice location

1250 Dearborn Dr
Columbus, OH 43085-4767

Mailing address

1250 Dearborn Dr
Columbus, OH 43085-4767
Phone (614) 840-3571

Other names 1

  • Kimberly Ann Randall Former name

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

LicenseStateTypeSpecialty
03127515OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1689108045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 DEARBORN DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "430854767",
            "telephone_number": "614-840-3571",
            "fax_number": "866-690-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 DEARBORN DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "430854767",
            "telephone_number": "614-840-3571",
            "fax_number": "866-690-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUKALICH",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03127515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "RANDALL",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.