Individual provider Active NPI

Kaitlin Rose Hacker, PHARMD

  • Pharmacist
  • Williamsville, NY
National Provider Identifier
1912557810
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
066006 Issued in NY
Practice address
480 Evans St
Williamsville, NY 14221-5670
Phone
(716) 632-1940
NPI assigned
Sep 13, 2019
Last updated
Jun 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 066006 NY Primary

Addresses

Primary practice location

480 Evans St
Williamsville, NY 14221-5670

Mailing address

13 Mason PL
Lancaster, NY 14086-1615
Phone (716) 650-8394

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
066006NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1912557810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 MASON PL",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "140861615",
            "telephone_number": "716-650-8394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 EVANS ST",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215670",
            "telephone_number": "716-632-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKER",
        "first_name": "KAITLIN",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "066006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.