Active NPI
Kendra Lynn Smith, RPH
- Pharmacist
- Saint Paul, MN
National Provider Identifier
1992075642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 117860
- Practice address
- 1788 Old Hudson Rd
Saint Paul, MN 55119-4307 - Phone
- (651) 731-9633
- Fax
- (651) 731-9678
- NPI assigned
- Jan 11, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 117860 | MN | Primary |
Addresses
Primary practice location
1788 Old Hudson Rd
Saint Paul, MN 55119-4307
Mailing address
1788 Old Hudson Rd
Saint Paul, MN 55119-4307
Phone (651) 731-9633
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
| License | State | Type | Specialty |
|---|---|---|---|
| 117860 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New 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": "1326240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326240000000",
"number": "1992075642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1788 OLD HUDSON RD",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551194307",
"telephone_number": "651-731-9633",
"fax_number": "651-731-9678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1788 OLD HUDSON RD",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551194307",
"telephone_number": "651-731-9633",
"fax_number": "651-731-9678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "KENDRA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-11",
"last_updated": "2012-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "117860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.