Active NPI
Danyelle Kimble
- Pharmacist
- Picayune, MS
National Provider Identifier
1689285777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E-15160
- Practice address
- 1505 Highway 43 S
Picayune, MS 39466-9297 - Phone
- (601) 889-9509
- NPI assigned
- Aug 12, 2020
- Last updated
- Aug 12, 2020
- Sex
- Female
- 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 | E-15160 | MS | Primary |
Addresses
Primary practice location
1505 Highway 43 S
Picayune, MS 39466-9297
Mailing address
1505 Highway 43 S
Picayune, MS 39466-9297
Phone (601) 889-9509
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-15160 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1505 Highway 43 S
Picayune, MS 39466
Phone (601) 889-9509
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597190400000",
"number": "1689285777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 HIGHWAY 43 S",
"city": "PICAYUNE",
"state": "MS",
"postal_code": "394669297",
"telephone_number": "601-889-9509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 HIGHWAY 43 S",
"city": "PICAYUNE",
"state": "MS",
"postal_code": "394669297",
"telephone_number": "601-889-9509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBLE",
"first_name": "DANYELLE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-12",
"last_updated": "2020-08-12",
"certification_date": "2020-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-15160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Picayune, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.