John Walter Kelly

Primary specialty

PharmacistTaxonomy code 183500000X

License

IN.0002009559 Issued in CO

Practice address

120 N Broadway
Denver, CO 80203-3917

Phone

(303) 722-0771

NPI assigned

Jun 2, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Walgreen Co

  • Community/Retail Pharmacy
  • Denver, CO
  • NPI 1184639429
  NPD
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1003509134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 N BROADWAY APT 450",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802032789",
            "telephone_number": "317-690-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N BROADWAY",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802033917",
            "telephone_number": "303-722-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOHN",
        "middle_name": "WALTER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "IN.0002009559",
            "primary": true
        },
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "CO",
            "license": "IN.0002009559",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia M Kelly, M.D.
• Erin Elizabeth Kelly
• Jessica Kelly, MSW
• Jillian Jane Kelly, LCSW
• John Patrick Kelly, MD
• Julie Kathleen Kelly, LAC
• Kyle B Kelly
• Lisa S. Kelly, PA
• Lorraine Noel Kelly
• Mackenzie Elizabeth Kelly, COTA/L

• Pharmacist in Denver, CO
• Providers in Denver, CO by specialty
• Pharmacist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.