Individual provider Active NPI

Kathy Lee Guptill, RPH

  • Pharmacist
  • Yelm, WA
National Provider Identifier
1902208705
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00040340 Issued in WA
Practice address
17100 State Route 507 SE
Yelm, WA 98597-7605
Phone
(360) 400-8062
Fax
(360) 400-8065
NPI assigned
Sep 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00040340 WA Primary
Pharmacist 183500000X 2862 MT
Pharmacist 183500000X 26016529A IN
Pharmacist 183500000X 009947 KY
Pharmacist 183500000X S007979 AZ

Addresses

Primary practice location

17100 State Route 507 SE
Yelm, WA 98597-7605

Mailing address

17100 State Route 507 SE
Yelm, WA 98597-7605
Phone (360) 400-8062

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
S007979AZMDPharmacist
26016529AINMDPharmacist
009947KYMDPharmacist
2862MTMDPharmacist
PH00040340WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1902208705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 STATE ROUTE 507 SE",
            "city": "YELM",
            "state": "WA",
            "postal_code": "985977605",
            "telephone_number": "360-400-8062",
            "fax_number": "360-400-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 STATE ROUTE 507 SE",
            "city": "YELM",
            "state": "WA",
            "postal_code": "985977605",
            "telephone_number": "360-400-8062",
            "fax_number": "360-400-8065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTILL",
        "first_name": "KATHY",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00040340",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "2862",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26016529A",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "009947",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S007979",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yelm, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.