Active NPI
Kristy Pezzino, PHARMD
- Pharmacotherapy Pharmacist
- Champaign, IL
National Provider Identifier
1700938834
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- PS35855
- Practice address
- 1103 Birkdale Dr
Champaign, IL 61822-8110 - Phone
- (217) 352-3865
- NPI assigned
- Jan 17, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | PS35855 | FL | Primary |
Addresses
Primary practice location
1103 Birkdale Dr
Champaign, IL 61822-8110
Mailing address
49 Zeya Drice
Coventry, CT 06238
Phone (860) 498-0063
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 |
|---|---|---|---|
| PS35855 | FL | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669852800000",
"number": "1700938834",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49 ZEYA DRICE",
"city": "COVENTRY",
"state": "CT",
"postal_code": "06238",
"telephone_number": "860-498-0063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1103 BIRKDALE DR",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618228110",
"telephone_number": "217-352-3865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEZZINO",
"first_name": "KRISTY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2022-12-01",
"certification_date": "2022-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "FL",
"license": "PS35855",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.