Active NPI
Kristin Ludolph, PHARM D
- Pharmacist
- Estero, FL
National Provider Identifier
1699107110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS50944
- Practice address
- 20311 Grande Oak Shoppes Blvd
Estero, FL 33928-7662 - Phone
- (239) 495-9013
- NPI assigned
- Aug 7, 2013
- Last updated
- Aug 7, 2013
- 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 | PS50944 | FL | Primary |
Addresses
Primary practice location
20311 Grande Oak Shoppes Blvd
Estero, FL 33928-7662
Mailing address
20311 Grande Oak Shoppes Blvd
Estero, FL 33928-7662
Phone (239) 495-9013
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 |
|---|---|---|---|
| PS50944 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Publix Super Markets Inc | Past | Accepting new patients | |
| Publix Super Markets Inc | Past | Accepting new patients |
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.
-
dba Publix Pharmacy #0847
- Community/Retail Pharmacy
- Estero, FL
- NPI 1184663130
-
dba Publix Pharmacy #2107
- Community/Retail Pharmacy
- Winter Haven, FL
- NPI 1760356380
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375833600000",
"number": "1699107110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20311 GRANDE OAK SHOPPES BLVD",
"city": "ESTERO",
"state": "FL",
"postal_code": "339287662",
"telephone_number": "239-495-9013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20311 GRANDE OAK SHOPPES BLVD",
"city": "ESTERO",
"state": "FL",
"postal_code": "339287662",
"telephone_number": "239-495-9013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUDOLPH",
"first_name": "KRISTIN",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-07",
"last_updated": "2013-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS50944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Estero, FL
- Liberty Personal LLC (Coconut Primary Care)
- Little Roots Behavioral Services
- David R Llewellyn
- Sarah Lombard
- Roberto Lopez, MA
- Elizabeth A Lunsford, IBCLC
- Luxottica of America Inc (Oakley B048)
- Luxottica of America Inc (LensCrafters #03356)
- Luxottica Retail North America Inc (Target Optical #C4425)
- Kristi-Leigh Lyon, M.A.CCC SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.