Active NPI
Diane Creslyn Davis-Yarbrough, RPH
- Pharmacist
- La Porte, TX
National Provider Identifier
1861091001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20413
- Practice address
- 1300 W Fairmont Pkwy
La Porte, TX 77571-6102 - Phone
- (281) 842-1022
- Fax
- (281) 842-1023
- NPI assigned
- Oct 19, 2020
- 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 | 20413 | TX | Primary |
Addresses
Primary practice location
1300 W Fairmont Pkwy
La Porte, TX 77571-6102
Mailing address
1135 Tiny Tree Dr
Missouri City, TX 77489-4103
Phone (713) 906-3994
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | diane.davis-yarbrough@stores.kroger.com | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| 20413 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Texas L P | Past | Accepting new patients | |
| Kroger Texas LP | 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.
-
- Community/Retail Pharmacy
- La Porte, TX
- NPI 1154494771
-
- Community/Retail Pharmacy
- Fort Worth, TX
- NPI 1407747439
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603065600000",
"number": "1861091001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1135 TINY TREE DR",
"city": "MISSOURI CITY",
"state": "TX",
"postal_code": "774894103",
"telephone_number": "713-906-3994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 W FAIRMONT PKWY",
"city": "LA PORTE",
"state": "TX",
"postal_code": "775716102",
"telephone_number": "281-842-1022",
"fax_number": "281-842-1023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS-YARBROUGH",
"first_name": "DIANE",
"middle_name": "CRESLYN",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-19",
"last_updated": "2020-10-19",
"certification_date": "2020-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "20413",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "diane.davis-yarbrough@stores.kroger.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "1300 W Fairmont Pkwy",
"city": "LA Porte",
"state": "TX",
"country_code": "US",
"postal_code": "775716102",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in La Porte, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.