Active NPI
Kristen Elizabeth Smith, RPH
- Pharmacist
- Winston Salem, NC
National Provider Identifier
1790163590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21325
- Practice address
- 2125 Cloverdale Ave
Winston Salem, NC 27103-2506 - Phone
- (336) 723-0561
- NPI assigned
- May 12, 2015
- 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 | 21325 | NC | Primary |
Addresses
Primary practice location
2125 Cloverdale Ave
Winston Salem, NC 27103-2506
Mailing address
2568 Huntington Woods Dr
Winston Salem, NC 27103-6634
Phone (336) 655-2269
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 |
|---|---|---|---|
| 21325 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431388800000",
"number": "1790163590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2568 HUNTINGTON WOODS DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271036634",
"telephone_number": "336-655-2269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2125 CLOVERDALE AVE",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271032506",
"telephone_number": "336-723-0561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "KRISTEN",
"middle_name": "ELIZABETH",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-12",
"last_updated": "2015-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "21325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.