Active NPI
Kim Lynn Jacoby, PHARMD
- Pharmacist
- Hood River, OR
National Provider Identifier
1912042128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 50642
- Practice address
- 606 State St
Hood River, OR 97031-1803 - Phone
- (541) 436-2575
- NPI assigned
- Feb 21, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14238 | NY | |
| Pharmacist | 183500000X | 50642 | CA | Primary |
Addresses
Primary practice location
606 State St
Hood River, OR 97031-1803
Mailing address
539 2ND Ave
San Francisco, CA 94118-4005
Phone (925) 285-8930
Other names 1
- Dr. Kim Lynn Frey
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 |
|---|---|---|---|
| 50642 | CA | MD | Marriage & Family Therapist |
| 14238 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377648000000",
"number": "1912042128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "539 2ND AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941184005",
"telephone_number": "925-285-8930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "606 STATE ST",
"city": "HOOD RIVER",
"state": "OR",
"postal_code": "970311803",
"telephone_number": "541-436-2575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBY",
"first_name": "KIM",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2013-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "14238",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "50642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIM",
"last_name": "FREY",
"middle_name": "LYNN",
"prefix": "DR.",
"credential": "PHARMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hood River, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.