Individual provider Active NPI

Kamren Gallon, PHARMACIST

  • Pharmacist
  • Newport News, VA
National Provider Identifier
1902409378
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202212283 Issued in VA
Practice address
12755 Jefferson Ave
Newport News, VA 23602-4317
Phone
(757) 877-3147
NPI assigned
Nov 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202212283 VA Primary

Addresses

Primary practice location

12755 Jefferson Ave
Newport News, VA 23602-4317

Mailing address

12755 Jefferson Ave
Newport News, VA 23602-4317
Phone (757) 877-3147

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

State licenses

LicenseStateTypeSpecialty
0202212283VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia CVS Pharmacy LLC PastSince Nov 22, 2020 Accepting new patients
Virginia CVS Pharmacy, L.L.C. PastSince Nov 22, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1902409378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12755 JEFFERSON AVE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024317",
            "telephone_number": "757-877-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12755 JEFFERSON AVE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236024317",
            "telephone_number": "757-877-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLON",
        "first_name": "KAMREN",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202212283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.

Verify at the official NPI Registry.