Individual provider Active NPI

Timothy S Kitchens, RPH

  • Pharmacist
  • Wilmington, NC
National Provider Identifier
1821362872
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
11904 Issued in AL
Practice address
2601 Castle Hayne Rd Ste B
Wilmington, NC 28401-2690
Phone
(910) 763-6231
Fax
(910) 763-2983
NPI assigned
Mar 7, 2012
Sex
Male
Sole proprietor
No

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

LicenseStateTypeSpecialty
11904ALMDPharmacist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 11904 AL Primary

Addresses

NPPES NPI Registry

Primary practice location

2601 Castle Hayne Rd Ste B
Wilmington, NC 28401-2690

Mailing address

831 S Carolina Rd
Vernon, AL 35592-3839
Phone (910) 620-4747

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
0655992MedicaidNC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 15, 2016.

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1821362872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 S CAROLINA RD",
            "city": "VERNON",
            "state": "AL",
            "postal_code": "355923839",
            "telephone_number": "910-620-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 CASTLE HAYNE RD STE B",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284012690",
            "telephone_number": "910-763-6231",
            "fax_number": "910-763-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITCHENS",
        "first_name": "TIMOTHY",
        "middle_name": "S",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-07",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "11904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0655992",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; 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.