Active NPI
Kyle Gregory Psilopoulos, PHARMD
- Pharmacist
- Gardnerville, NV
National Provider Identifier
1972092021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19228
- Practice address
- 1329 US Highway 395 N
Gardnerville, NV 89410-5391 - Phone
- (775) 782-7042
- NPI assigned
- May 3, 2018
- Sex
- Male
- 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 | 19228 | NV | Primary |
| Pharmacist | 183500000X | 74434 | CA |
Addresses
Primary practice location
1329 US Highway 395 N
Gardnerville, NV 89410-5391
Mailing address
1097 Onnontioga St
South Lake Tahoe, CA 96150-5901
Phone (530) 416-2627
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19228 | Other | NV | PHARMACIST STATE LICENSE |
| 74434 | Other | CA | PHARMACIST STATE LICENSE |
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 |
|---|---|---|---|
| 19228 | NV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525305600000",
"number": "1972092021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1097 ONNONTIOGA ST",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961505901",
"telephone_number": "530-416-2627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1329 US HIGHWAY 395 N",
"city": "GARDNERVILLE",
"state": "NV",
"postal_code": "894105391",
"telephone_number": "775-782-7042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PSILOPOULOS",
"first_name": "KYLE",
"middle_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-03",
"last_updated": "2018-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "19228",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "74434",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST STATE LICENSE",
"identifier": "19228",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST STATE LICENSE",
"identifier": "74434",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gardnerville, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.