Kentucky Pharmacy #1, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

P07678 Issued in KY

Legal business name

KENTUCKY PHARMACY #1, LLC

Practice address

182 Frankfort Rd
Shelbyville, KY 40065-9433

Phone

(502) 437-3008

NPI assigned

Jul 20, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jason Elliott Underwood, PHARMDNPI 1497342000

Title

Sole Member

Phone

(502) 437-3008

Specialties & licenses 1

Addresses

Other names 1

• SHELBYVILLE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Tax ID family

Kentucky Pharmacy 1 LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kentucky Pharmacy #1, LLC

  • Long Term Care Pharmacy
  • Shelbyville, KY
  • NPI 1235990615
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Elliott Underwood, PHARMD

  • Pharmacist
  • Shelbyville, KY
  • NPI 1497342000
  NPD Authorized official
• Matthew Allen Roberts, RPH

  • Pharmacist
  • Shelbyville, KY
  • NPI 1942177654
  NPD

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740700800000",
    "number": "1063897015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1248",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400661248",
            "telephone_number": "502-437-3008",
            "fax_number": "502-437-3607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 FRANKFORT RD",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400659433",
            "telephone_number": "502-437-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY PHARMACY #1, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-20",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "ELLIOTT",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "502-437-3008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "P07678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHELBYVILLE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kentucky Pharmacy #1, LLC
• Kentucky Student Services
• Erika Keplinger, LCADC
• Kids Health Services, LLC
• Esther Kim, BCBA

• Community/Retail Pharmacy in Shelbyville, KY
• Providers in Shelbyville, KY by specialty
• Community/Retail Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.