Individual provider Active NPI

Olga Kajobe Kisembo

  • Pharmacist
  • Everett, MA
National Provider Identifier
1982332276
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH240815 Issued in MA
Practice address
51 Morris St
Everett, MA 02149-2922
Phone
(617) 849-3015
NPI assigned
Aug 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 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 PH240815 MA Primary

Addresses

Primary practice location

51 Morris St
Everett, MA 02149-2922

Mailing address

51 Morris St
Everett, MA 02149-2922
Phone (617) 849-3015

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
PH240815MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1982332276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 MORRIS ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021492922",
            "telephone_number": "617-849-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 MORRIS ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021492922",
            "telephone_number": "617-849-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISEMBO",
        "first_name": "OLGA",
        "middle_name": "KAJOBE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH240815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.