Individual provider Active NPI

Kip Alan Eberwein, R.PH.

  • Pharmacist
  • Lexington, KY
National Provider Identifier
1952466039
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
008994 Issued in KY
Practice address
1 Saint Joseph Dr
Lexington, KY 40504-3742
Phone
(859) 313-7124
Fax
(859) 313-2304
NPI assigned
Dec 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 008994 KY Primary

Addresses

Primary practice location

1 Saint Joseph Dr
Lexington, KY 40504-3742

Mailing address

223 Brookstown Rd
Richmond, KY 40475-9200
Phone (859) 624-9027

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
008994KYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952466039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 BROOKSTOWN RD",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404759200",
            "telephone_number": "859-624-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT JOSEPH DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043742",
            "telephone_number": "859-313-7124",
            "fax_number": "859-313-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERWEIN",
        "first_name": "KIP",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "008994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.