Individual provider Active NPI

Lisa Minecci Kutney, PHARM.D., R.PH.

  • Pharmacist
  • Philadelphia, PA
National Provider Identifier
1861805129
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP445354 Issued in PA
Practice address
12311 Academy Rd
Philadelphia, PA 19154-1927
Phone
(215) 637-4690
Fax
(215) 637-6121
NPI assigned
Jun 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP445354 PA Primary
Pharmacist 183500000X RPI006334 PA
Pharmacist 183500000X 28RI02452800 NJ
Pharmacist 183500000X PH8266 SC

Addresses

Primary practice location

12311 Academy Rd
Philadelphia, PA 19154-1927

Mailing address

12311 Academy Rd
Philadelphia, PA 19154-1927
Phone (215) 637-4690

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
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI02452800NJMDPharmacist
RP445354PAMDPharmacist
RPI006334PAMDPharmacist
PH8266SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Pennsylvania LLC Past Accepting new patients
Rite Aid of Pennsylvania LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1861805129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12311 ACADEMY RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191541927",
            "telephone_number": "215-637-4690",
            "fax_number": "215-637-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12311 ACADEMY RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191541927",
            "telephone_number": "215-637-4690",
            "fax_number": "215-637-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTNEY",
        "first_name": "LISA",
        "middle_name": "MINECCI",
        "credential": "PHARM.D., R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP445354",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RPI006334",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02452800",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "PH8266",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.