Active NPI
Kimberly Kaye Merrill, RPH
- Pharmacist
- Clarkston, WA
National Provider Identifier
1811058605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00021095
- Practice address
- 1275 Highland Ave
Clarkston, WA 99403-2846 - Phone
- (509) 758-5533
- Fax
- (509) 751-9545
- NPI assigned
- Dec 13, 2006
- Last updated
- Feb 18, 2010
- 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 | PH00021095 | WA | Primary |
Addresses
Primary practice location
1275 Highland Ave
Clarkston, WA 99403-2846
Mailing address
1941 Sargent Dr
Clarkston, WA 99403-1244
Phone (509) 552-9338
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6173801 | Medicaid | WA | |
| 4902981 | Other | WA | NABP NUMBER |
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 |
|---|---|---|---|
| PH00021095 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chastains Inc | Past | Accepting new patients | |
| Chastains Inc | 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, 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": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266451200000",
"number": "1811058605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1941 SARGENT DR",
"city": "CLARKSTON",
"state": "WA",
"postal_code": "994031244",
"telephone_number": "509-552-9338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 HIGHLAND AVE",
"city": "CLARKSTON",
"state": "WA",
"postal_code": "994032846",
"telephone_number": "509-758-5533",
"fax_number": "509-751-9545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRILL",
"first_name": "KIMBERLY",
"middle_name": "KAYE",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2010-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00021095",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6173801",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP NUMBER",
"identifier": "4902981",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clarkston, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.