Individual provider Active NPI

Kendra Lynn Thomas, RPH

  • Pharmacist
  • Mahomet, IL
National Provider Identifier
1871861195
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051289883 Issued in IL
Practice address
104 N Lombard St
Mahomet, IL 61853-9097
Phone
(217) 586-3460
Fax
(217) 586-3523
NPI assigned
Dec 1, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051289883 IL Primary

Addresses

Primary practice location

104 N Lombard St
Mahomet, IL 61853-9097

Mailing address

104 N Lombard St
Mahomet, IL 61853-9097
Phone (217) 586-3460

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
051289883ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1871861195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N LOMBARD ST",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618539097",
            "telephone_number": "217-586-3460",
            "fax_number": "217-586-3523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N LOMBARD ST",
            "city": "MAHOMET",
            "state": "IL",
            "postal_code": "618539097",
            "telephone_number": "217-586-3460",
            "fax_number": "217-586-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KENDRA",
        "middle_name": "LYNN",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051289883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahomet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.