Individual provider Active NPI

Kristi Lynn Roman, PHARMD

  • Pharmacist
  • Port St Lucie, FL
National Provider Identifier
1972272375
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS62885 Issued in FL
Practice address
692 SW Prima Vista Blvd
Port St Lucie, FL 34983-1835
Phone
(772) 879-0522
Fax
(772) 871-9669
NPI assigned
Sep 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 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 PS62885 FL Primary

Addresses

Primary practice location

692 SW Prima Vista Blvd
Port St Lucie, FL 34983-1835

Mailing address

3374 SW West Globe St
Port St Lucie, FL 34953-3435
Phone (772) 240-9882

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
PS62885FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pills Potions & Lotions PastSince Sep 1, 2021 Accepting new patients
Pills Potions & Lotions PastSince Sep 1, 2021 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": "1631145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1972272375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3374 SW WEST GLOBE ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349533435",
            "telephone_number": "772-240-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "692 SW PRIMA VISTA BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349831835",
            "telephone_number": "772-879-0522",
            "fax_number": "772-871-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "KRISTI",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-09",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS62885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.