Individual provider Active NPI

Kimberly Ann-Marie Grant, RPH

  • Pharmacist
  • Pinole, CA
National Provider Identifier
1871180703
Registry record updated Dec 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
83600 Issued in CA
Practice address
1617 Canyon Dr
Pinole, CA 94564-2151
Phone
(510) 724-8880
NPI assigned
Dec 27, 2020
Last updated
Dec 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 83600 CA Primary

Addresses

Primary practice location

1617 Canyon Dr
Pinole, CA 94564-2151

Mailing address

2015 19TH St
San Pablo, CA 94806-3527

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Kimberly.Grant@CVSHealth.com

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
83600CAMDPharmacist

Interoperability endpoints

  • Direct secure messaging: kimberly.grant@cvshealth.com

NPI Registry JSON

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

{
    "created_epoch": "1609027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609027200000",
    "number": "1871180703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 19TH ST",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 CANYON DR",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642151",
            "telephone_number": "510-724-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "KIMBERLY",
        "middle_name": "ANN-MARIE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-27",
        "last_updated": "2020-12-27",
        "certification_date": "2020-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "83600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kimberly.Grant@CVSHealth.com",
            "affiliation": "N",
            "endpointDescription": "CVS Pharmacy email",
            "address_1": "1617 Canyon Dr",
            "city": "Pinole",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945642151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pinole, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.