Kelsey Ellen Dimarzio

Primary specialty

PharmacistTaxonomy code 183500000X

License

26029868A Issued in IN

Practice address

30830 Old US 20
Elkhart, IN 46514-9481

Phone

(574) 674-5730

NPI assigned

Aug 2, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wal-Mart Stores East LP

  • Community/Retail Pharmacy
  • Elkhart, IN
  • NPI 1902082324
  NPD (past)
• Wal-Mart Stores East, LP

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1063149839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51315 GOLFVIEW CT",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465306502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30830 OLD US 20",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465149481",
            "telephone_number": "574-674-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMARZIO",
        "first_name": "KELSEY",
        "middle_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26029868A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Gerard Dibley, D.C.
• Michael John Dibley Jr., D.C.,C.C.S.P
• Dustin Tyler Diggs, CRNA
• Kristina Lee Dik, OT
• Hannah Dillman
• Patricia Rose Dimarzio
• Caleb David Dingeldein, PT
• Francis M Disori, LCSW
• Barbara Jo Ditmer, C.O.T.A.
• Stefan Dixon

• Pharmacist in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Pharmacist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.