Active NPI
Kaitlyn George, PHARMD
- Pharmacist
- Grand Rapids, MI
National Provider Identifier
1871917047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302039482
- Practice address
- 300 68TH St SE
Ste 131
Grand Rapids, MI 49548 - Phone
- (616) 498-7549
- NPI assigned
- Feb 9, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302039482 | MI | Primary |
Addresses
Primary practice location
300 68TH St SE
Ste 131
Grand Rapids, MI 49548
Mailing address
344 Tampa St SE
Kentwood, MI 49548-5863
Phone (269) 757-6292
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871917047 | Other | NPPES |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5302039482 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604016000000",
"number": "1871917047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "344 TAMPA ST SE",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495485863",
"telephone_number": "269-757-6292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 68TH ST SE",
"address_2": "STE 131",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49548",
"telephone_number": "616-498-7549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGE",
"first_name": "KAITLYN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-09",
"last_updated": "2020-10-30",
"certification_date": "2020-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302039482",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPPES",
"identifier": "1871917047",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.