Individual provider Active NPI

Lori Jean Kearney, RPH

  • Pharmacist
  • Durango, CO
National Provider Identifier
1861693988
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
12196 Issued in CO
Practice address
575 Rivergate LN Unit 111
Durango, CO 81301-7490
Phone
(970) 375-7711
Fax
(970) 375-7722
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 12196 CO Primary

Addresses

Primary practice location

575 Rivergate LN Unit 111
Durango, CO 81301-7490

Mailing address

760 Cherry Gulch Rd
Durango, CO 81301-6471
Phone (970) 247-8016

Other identifiers 1

IdentifierTypeStateIssuer
12196OtherCO183500000X

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
12196COMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sano Vita Inc PastSince Apr 21, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1861693988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 CHERRY GULCH RD",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813016471",
            "telephone_number": "970-247-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 RIVERGATE LN UNIT 111",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813017490",
            "telephone_number": "970-375-7711",
            "fax_number": "970-375-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARNEY",
        "first_name": "LORI",
        "middle_name": "JEAN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "12196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "183500000X",
            "identifier": "12196",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; 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.