Individual provider Active NPI

Kelly Drahota, PHARMD

  • Pharmacist
  • Rich Hill, MO
National Provider Identifier
1104942580
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2002027551 Issued in MO
Practice address
301 N 14TH St
Rich Hill, MO 64779-2146
Phone
(417) 395-4700
Fax
(417) 395-2112
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2002027551 MO Primary

Addresses

Primary practice location

301 N 14TH St
Rich Hill, MO 64779-2146

Mailing address

301 N 14TH St
PO Box 70
Rich Hill, MO 64779-2146
Phone (417) 395-4700

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
2002027551MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104942580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N 14TH ST",
            "address_2": "PO BOX 70",
            "city": "RICH HILL",
            "state": "MO",
            "postal_code": "647792146",
            "telephone_number": "417-395-4700",
            "fax_number": "417-395-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 14TH ST",
            "city": "RICH HILL",
            "state": "MO",
            "postal_code": "647792146",
            "telephone_number": "417-395-4700",
            "fax_number": "417-395-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAHOTA",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2002027551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rich Hill, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.