Active NPI
Kyle Ryan Mick, PHARMD
- Pharmacist
- Lawrence, KS
National Provider Identifier
1730799909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 1-100868
- Practice address
- 325 Maine St
Lawrence, KS 66044-1360 - Phone
- (785) 505-6256
- NPI assigned
- Aug 3, 2020
- Last updated
- Aug 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 1-100868 | KS | Primary |
Addresses
Primary practice location
325 Maine St
Lawrence, KS 66044-1360
Mailing address
105 Sin del Dr
Holton, KS 66436-1963
Phone (785) 305-0749
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 |
|---|---|---|---|
| 1-100868 | KS | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596412800000",
"number": "1730799909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 SIN DEL DR",
"city": "HOLTON",
"state": "KS",
"postal_code": "664361963",
"telephone_number": "785-305-0749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 MAINE ST",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660441360",
"telephone_number": "785-505-6256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICK",
"first_name": "KYLE",
"middle_name": "RYAN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-03",
"last_updated": "2020-08-03",
"certification_date": "2020-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KS",
"license": "1-100868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.