Megan Nissen Kelley, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS60181 Issued in FL

Practice address

4730 S Florida Ave
Lakeland, FL 33813-2181

Phone

(863) 646-5471

NPI assigned

Jul 19, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Megan Nissen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

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.

• Publix Super Markets, Inc.

  • Community/Retail Pharmacy
  • Lakeland, FL
  • NPI 1316988801
  NPD
• Publix Super Markets Inc

  • Community/Retail Pharmacy
  • Mulberry, FL
  • NPI 1437198306
  NPD (past)
• Publix Super Markets Inc

  • Community/Retail Pharmacy
  • Winter Haven, FL
  • NPI 1760356380
  NPD (past)
• Med Mart Weco LLC

  • Long Term Care Pharmacy
  • West Columbia, SC
  • NPI 1598579443
  NPD (past)
• Med Mart Weco LLC

  • Community/Retail Pharmacy
  • West Columbia, SC
  • NPI 1598858987

  Pharmacist

  NPD (past)

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655510400000",
    "number": "1093291361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132181",
            "telephone_number": "863-646-5471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132181",
            "telephone_number": "863-646-5471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "29169",
            "country_code": "US",
            "telephone_number": "803-791-7043",
            "fax_number": "803-796-1517",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6031 Cypress Gardens Blvd",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "33884",
            "country_code": "US",
            "telephone_number": "863-324-1557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2040 Shepherd Rd",
            "address_purpose": "LOCATION",
            "city": "Mulberry",
            "state": "FL",
            "postal_code": "338608699",
            "country_code": "US",
            "telephone_number": "863-644-5929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "MEGAN",
        "middle_name": "NISSEN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2022-06-18",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "37752",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS60181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "NISSEN",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Holly Kegel, LMHC, LPC
• Keith Gordon Kehler
• Keith Hilliard DMD PA
• D'Laynie Keith
• Louise Elizabeth Kelley, MS, RN, FNP-C
• Scott T. Kelley, MD
• Kelly a. Poncheri DPM PA
• Alaina Kelly
• Joseph Lee Kelly, COUNSELOR
• Larissa Kelly, CCC-SLP

• Pharmacist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.