Individual provider Active NPI

Kayla Marie Peltier, PHARM.D.

  • Pharmacist
  • Port Arthur, TX
National Provider Identifier
1013517564
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
63637 Issued in TX
Practice address
8585 Memorial Blvd
Port Arthur, TX 77640-7012
Phone
(409) 724-0054
Fax
(409) 722-6964
NPI assigned
Oct 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 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 63637 TX Primary

Addresses

Primary practice location

8585 Memorial Blvd
Port Arthur, TX 77640-7012

Mailing address

8585 Memorial Blvd
Port Arthur, TX 77640-7012
Phone (409) 724-0054

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
63637TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores Texas, LLC PastSince Nov 1, 2020 Accepting new patients
Wal-Mart Stores Texas LLC PastSince Nov 1, 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": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1013517564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8585 MEMORIAL BLVD",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776407012",
            "telephone_number": "409-724-0054",
            "fax_number": "409-722-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8585 MEMORIAL BLVD",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776407012",
            "telephone_number": "409-724-0054",
            "fax_number": "409-722-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTIER",
        "first_name": "KAYLA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "63637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.