NPIMap

Individual provider Active NPI

Kris Anagnostu

  • Pharmacist
  • Port Saint Lucie, FL
National Provider Identifier
1962784710
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS41828 Issued in FL
Practice address
2901 SW Port St Lucie Blvd
Port Saint Lucie, FL 34953-3222
Phone
(772) 336-3108
NPI assigned
Sep 16, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS41828 FL Primary

Addresses

Primary practice location

2901 SW Port St Lucie Blvd
Port Saint Lucie, FL 34953-3222

Mailing address

2901 SW Port St Lucie Blvd
Port Saint Lucie, FL 34953-3222
Phone (772) 336-3108

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
PS41828FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1962784710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 SW PORT ST LUCIE BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349533222",
            "telephone_number": "772-336-3108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 SW PORT ST LUCIE BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349533222",
            "telephone_number": "772-336-3108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANAGNOSTU",
        "first_name": "KRIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-16",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS41828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; 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.