Active NPI
Mai Thanh Kim, PHARMD
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Mansfield, TX
National Provider Identifier
1902427610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 47461
- Practice address
- 3001 Matlock Rd
Mansfield, TX 76063-3302 - Phone
- (817) 473-0081
- NPI assigned
- May 4, 2020
- Last updated
- May 12, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 47461 | TX | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 47461 | TX | Primary |
| Ambulatory Care Pharmacist | 1835P2201X | 6150671 | TX |
Addresses
Primary practice location
3001 Matlock Rd
Mansfield, TX 76063-3302
Mailing address
3001 Matlock Rd
Mansfield, TX 76063-3302
Phone (817) 473-0081
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 |
|---|---|---|---|
| 47461 | TX | MD | Pharmacist |
| 6150671 | TX | MD | Ambulatory Care Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Texas LP | Past | Accepting new patients | |
| Kroger Texas L P | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589241600000",
"number": "1902427610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 MATLOCK RD",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760633302",
"telephone_number": "817-473-0081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 MATLOCK RD",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760633302",
"telephone_number": "817-473-0081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MAI",
"middle_name": "THANH",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-04",
"last_updated": "2020-05-12",
"certification_date": "2020-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "47461",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "TX",
"license": "47461",
"primary": true
},
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "TX",
"license": "6150671",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
- Kerstin a Archer, MD, PA
- Khuong Phan, D.O., P.a. (Mansfield Medical Associates)
- Kidsville Pediatrics Mansfield
- Kidsville Pediatrics PLLC
- Kim Pham Co (Select Vision Care)
- Young Kyu Kim, DMD
- Timothy Kimuyu, APRN
- Kindred Hospitals Limited Partnership (Kindred Hospital - Mansfield)
- Robin Patrice Kindred, M.D.
- Amari King
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.