Active NPI
Kathy M Kalista, RPH
- Pharmacist
- Deep River, CT
National Provider Identifier
1992935779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 009197
- Practice address
- 180 Main St
Deep River, CT 06417-2039 - Phone
- (860) 526-8052
- NPI assigned
- Jul 15, 2009
- Last updated
- Jul 15, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | 009197 | CT | Primary |
Addresses
Primary practice location
180 Main St
Deep River, CT 06417-2039
Mailing address
180 Main St
Deep River, CT 06417-2039
Phone (860) 526-8052
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 |
|---|---|---|---|
| 009197 | CT | MD | Acute Care Nurse Practitioner |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247616000000",
"number": "1992935779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 MAIN ST",
"city": "DEEP RIVER",
"state": "CT",
"postal_code": "064172039",
"telephone_number": "860-526-8052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 MAIN ST",
"city": "DEEP RIVER",
"state": "CT",
"postal_code": "064172039",
"telephone_number": "860-526-8052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALISTA",
"first_name": "KATHY",
"middle_name": "M",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-15",
"last_updated": "2009-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "009197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deep River, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.