Individual provider Active NPI

Kristen A Engelen, PHARM D

  • Pharmacist
  • St Petersburg, FL
National Provider Identifier
1790922763
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19803 Issued in NC
Practice address
1211 1St Ave N Ste 204
Saint Petersburg, FL 33705-1567
Phone
(866) 234-4974
NPI assigned
Jan 13, 2009
Last updated
Mar 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19803 NC Primary
Ambulatory Care Pharmacist 1835P2201X PS50111 FL

Addresses

Primary practice location

1211 1St Ave N Ste 204
Saint Petersburg, FL 33705-1567

Mailing address

1211 1St Ave N Ste 204
Saint Petersburg, FL 33705-1567
Phone (866) 234-4974

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
19803NCMDPharmacist
PS50111FLMDAmbulatory Care Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rxlive Florida LLC Pharmacist CurrentSince Apr 3, 2022 Accepting new patients
Rxlive, Inc. CurrentSince Apr 24, 2022 Accepting new patients

Locations

1211 1st Ave N
Ste 204
St Petersburg, FL 33705
Phone (866) 234-4974

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.

NPI Registry JSON

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1790922763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 1ST AVE N STE 204",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337051567",
            "telephone_number": "866-234-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 1ST AVE N STE 204",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337051567",
            "telephone_number": "866-234-4974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELEN",
        "first_name": "KRISTEN",
        "middle_name": "A",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-13",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "19803",
            "primary": true
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "FL",
            "license": "PS50111",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.