Individual provider Active NPI

Kimberly Ann Harroun, PHARMD

  • Pharmacist
  • Syracuse, NY
National Provider Identifier
1902135031
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
053573 Issued in NY
Practice address
307 Nottingham Rd
Syracuse, NY 13210-3453
Phone
(315) 214-5097
Fax
(315) 314-6606
NPI assigned
Dec 20, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 053573 NY Primary

Addresses

Primary practice location

307 Nottingham Rd
Syracuse, NY 13210-3453

Mailing address

307 Nottingham Rd
Syracuse, NY 13210-3453
Phone (315) 214-5097

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
053573NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
KPH Healthcare Services, Inc. PastSince Nov 1, 2020 Accepting new patients
KPH Healthcare Services, Inc. PastSince Nov 1, 2020 Accepting new patients
KPH Healthcare Services, Inc. PastSince Aug 25, 2024 Accepting new patients

Organizations & group practices 3

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": "1261267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1902135031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 NOTTINGHAM RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132103453",
            "telephone_number": "315-214-5097",
            "fax_number": "315-314-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 NOTTINGHAM RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132103453",
            "telephone_number": "315-214-5097",
            "fax_number": "315-314-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARROUN",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "053573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.