Individual provider Active NPI

Kennedy Hart Merical, PHARMD

  • Pharmacist
  • Ankeny, IA
National Provider Identifier
1033886643
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
24207 Issued in IA
Practice address
107 NE Delaware Ave Ste 6
Ankeny, IA 50021-6691
Phone
(515) 964-8550
Fax
(515) 963-4055
NPI assigned
Aug 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 24207 IA Primary

Addresses

Primary practice location

107 NE Delaware Ave Ste 6
Ankeny, IA 50021-6691

Mailing address

107 NE Delaware Ave Ste 6
Ankeny, IA 50021-6691
Phone (515) 964-8550

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
24207IAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1033886643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 NE DELAWARE AVE STE 6",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500216691",
            "telephone_number": "515-964-8550",
            "fax_number": "515-963-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 NE DELAWARE AVE STE 6",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500216691",
            "telephone_number": "515-964-8550",
            "fax_number": "515-963-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERICAL",
        "first_name": "KENNEDY",
        "middle_name": "HART",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "24207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.