Individual provider Active NPI

Kelsa Reynolds

  • Pharmacist
  • Indianapolis, IN
National Provider Identifier
1073158309
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26026614A Issued in IN
Practice address
1545 N Meridian St
Indianapolis, IN 46202-2306
Phone
(317) 923-1491
NPI assigned
Nov 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26026614A IN Primary

Addresses

Primary practice location

1545 N Meridian St
Indianapolis, IN 46202-2306

Mailing address

1545 N Meridian St
Indianapolis, IN 46202-2306

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

State licenses

LicenseStateTypeSpecialty
26026614AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1073158309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022306",
            "telephone_number": "317-923-1491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "KELSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-11",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26026614A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; 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.