Individual provider Active NPI

Kelsey Echelbarger, PHARMD

  • Pharmacist
  • Bowling Green, OH
National Provider Identifier
1083902779
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH.03331009-3 Issued in OH
Practice address
536 Pearl St
Bowling Green, OH 43402-2730
Phone
(419) 595-0685
NPI assigned
Jul 14, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 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 RPH.03331009-3 OH Primary

Addresses

Primary practice location

536 Pearl St
Bowling Green, OH 43402-2730

Mailing address

PO Box 134
Portage, OH 43451-0134
Phone (419) 595-0685

Other practice location 1

2801 Bay Park Dr
Oregon, OH 43616-4920
Phone (419) 690-8721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210526003164 OH Practitioner - Mass Immunization Roster Biller 1254730096 Practice locations: Bowling Green, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH.03331009-3OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Huntington Chiropractic & Wellness LLC CurrentSince May 25, 2021 Accepting new patients
Omni Medical Services Inc CurrentSince Sep 7, 2021 Accepting new patients

Locations

536 Pearl St
Bowling Green, OH 43402
Phone (419) 352-8946

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1083902779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 134",
            "city": "PORTAGE",
            "state": "OH",
            "postal_code": "434510134",
            "telephone_number": "419-595-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 PEARL ST",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022730",
            "telephone_number": "419-595-0685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 Bay Park Dr",
            "address_purpose": "LOCATION",
            "city": "Oregon",
            "state": "OH",
            "postal_code": "436164920",
            "country_code": "US",
            "telephone_number": "419-690-8721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ECHELBARGER",
        "first_name": "KELSEY",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "RPH.03331009-3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.