Individual provider Active NPI

Kristin Lee Bearden, PHARMD

  • Pharmacist
  • Tulsa, OK
National Provider Identifier
1871887034
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14427 Issued in OK
Practice address
10019 S Memorial Dr
Tulsa, OK 74133-6103
Phone
(918) 615-5001
Fax
(918) 615-5011
NPI assigned
Jun 6, 2011
Last updated
Jun 6, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 14427 OK Primary
Pharmacist 183500000X 47132 TX

Addresses

Primary practice location

10019 S Memorial Dr
Tulsa, OK 74133-6103

Mailing address

10019 S Memorial Dr
Tulsa, OK 74133-6103
Phone (918) 615-5001

Other identifiers 1

IdentifierTypeStateIssuer
100851520BMedicaidOK

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

State licenses

LicenseStateTypeSpecialty
14427OKMDPharmacist
47132TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1871887034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10019 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741336103",
            "telephone_number": "918-615-5001",
            "fax_number": "918-615-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10019 S MEMORIAL DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741336103",
            "telephone_number": "918-615-5001",
            "fax_number": "918-615-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARDEN",
        "first_name": "KRISTIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "14427",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "47132",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100851520B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.