Individual provider Active NPI

Almira Koentjoro

  • Pharmacist
  • Olathe, KS
National Provider Identifier
1992308373
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
1-14248 Issued in KS
Practice address
1785 S Mur Len Rd
Olathe, KS 66062-2611
Phone
(913) 390-9892
NPI assigned
Nov 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 1-14248 KS Primary

Addresses

Primary practice location

1785 S Mur Len Rd
Olathe, KS 66062-2611

Mailing address

1785 S Mur Len Rd
Olathe, KS 66062-2611

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
1-14248KSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas CVS Pharmacy, L.L.C. PastSince Nov 22, 2020 Accepting new patients
Kansas CVS Pharmacy, L.L.C PastSince Nov 22, 2020 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": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1992308373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1785 S MUR LEN RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660622611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 S MUR LEN RD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660622611",
            "telephone_number": "913-390-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENTJORO",
        "first_name": "ALMIRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-14248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.