Individual provider Active NPI

Kenneth G Morin, PHARM.D.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Sparks, NV
National Provider Identifier
1720415953
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
16113 Issued in NV
Practice address
4810 Galleria Pkwy
Sparks, NV 89436-9605
Phone
(775) 356-4409
NPI assigned
Oct 2, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 55302 CA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 16113 NV Primary
Pharmacist 183500000X 16113 NV

Addresses

Primary practice location

4810 Galleria Pkwy
Sparks, NV 89436-9605

Mailing address

4810 Galleria Pkwy
Sparks, NV 89436-9605
Phone (775) 356-4409

Other practice location 1

5260 W 7th St
Reno, NV 89523-2332
Phone (775) 624-2080

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
16113NVMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1720415953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4810 GALLERIA PKWY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894369605",
            "telephone_number": "775-356-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 GALLERIA PKWY",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894369605",
            "telephone_number": "775-356-4409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5260 W 7th St",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895232332",
            "country_code": "US",
            "telephone_number": "775-624-2080",
            "fax_number": "775-624-2083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORIN",
        "first_name": "KENNETH",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-02",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "55302",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NV",
            "license": "16113",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "16113",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.

Verify at the official NPI Registry.