Kellylynne Forest, CPHT

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

PT00013188 Issued in NM

Practice address

123 Madeira Dr SE
Albuquerque, NM 87108-2963

Phone

(505) 262-1538

Fax

(505) 243-5342

NPI assigned

Dec 16, 2020

Sex

Female

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.

• Albuquerque Treatment Services LLC

  • Methadone Clinic
  • Albuquerque, NM
  • NPI 1801032958
  NPD

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1023604873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10411 TOWNER AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871123060",
            "telephone_number": "541-250-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 MADEIRA DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082963",
            "telephone_number": "505-262-1538",
            "fax_number": "505-243-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOREST",
        "first_name": "KELLYLYNNE",
        "credential": "CPHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "AZ",
            "license": "T066714",
            "primary": false
        },
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "NM",
            "license": "PT00013188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Merrilee Foreman, D.C.
• Robert Erwin Foreman, M.D., PH.D
• Forensic Behavioral Health Associates
• Forensic Treatment Services
• Megan M Foresi, LMT
• Forever 29 LLC
• Scott Andrew Forman, M.D.
• Walter B Forman, MD
• Formation Counseling Services Inc
• Erin Lynn Forrest, INTERN

• Pharmacy Technician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Pharmacy Technician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.