Active NPI
Kristen Lynn Gray-Mitchell, RPH
- Pharmacist
- Irmo, SC
National Provider Identifier
1689707143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9499
- Practice address
- 7338 Broad River Rd
Irmo, SC 29063-9639 - Phone
- (803) 749-8110
- NPI assigned
- Mar 13, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9499 | SC | Primary |
| Pharmacist | 183500000X | 03-2-21253 | OH |
Addresses
Primary practice location
7338 Broad River Rd
Irmo, SC 29063-9639
Mailing address
8 Kings Creek CT
Irmo, SC 29063-8218
Phone (803) 361-9684
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9499 | SC | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689707143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 KINGS CREEK CT",
"city": "IRMO",
"state": "SC",
"postal_code": "290638218",
"telephone_number": "803-361-9684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7338 BROAD RIVER RD",
"city": "IRMO",
"state": "SC",
"postal_code": "290639639",
"telephone_number": "803-749-8110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY-MITCHELL",
"first_name": "KRISTEN",
"middle_name": "LYNN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "9499",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03-2-21253",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irmo, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.