Kallie Marie Supernor, PHARM.D

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

29897 Issued in NC

Practice address

1724 Fordham Blvd
Chapel Hill, NC 27514-5808

Phone

(919) 942-5125

NPI assigned

Sep 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• South Carolina CVS Pharmacy LLC

  • Pharmacy
  • Anderson, SC
  • NPI 1114020971
  NPD (past)

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

{
    "created_epoch": "1600473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600473600000",
    "number": "1841806429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 AARON CIR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277133201",
            "telephone_number": "978-314-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 FORDHAM BLVD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275145808",
            "telephone_number": "919-942-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPERNOR",
        "first_name": "KALLIE",
        "middle_name": "MARIE",
        "credential": "PHARM.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-19",
        "last_updated": "2020-09-19",
        "certification_date": "2020-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NC",
            "license": "29897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Sun, PHARMD
• Elizabeth Sunde, MD
• Anna Sundy, ATC
• Kristin Sundy
• Julia Anne Marsh Sung, M.D.
• Donna Supple
• Vidhya Suresh, MD, ATC
• Michelle Lynn Surovec, PA-C
• Kaddie Surratt, CPO
• Serkan Surucu, MD

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.

Verify at the official NPI Registry.