Active NPI
James Clifton Kelly III, RPH
- Pharmacist
- Collins, MS
National Provider Identifier
1114134285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E06945
- Practice address
- 204 Main St
Collins, MS 39428-0327 - Phone
- (601) 765-6817
- NPI assigned
- May 17, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E06945 | MS | Primary |
Addresses
Primary practice location
204 Main St
Collins, MS 39428-0327
Mailing address
PO Box 327
Collins, MS 39428-0327
Phone (601) 765-6817
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E06945 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| C & C Drugs Inc | Current | Accepting new patients | |
| C & C Drugs Inc | Current | Accepting new patients |
Locations
204 Main St
Collins, MS 39428
Phone (601) 765-6817
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 and National Provider Directory roles.
-
- Long Term Care Pharmacy
- Collins, MS
- NPI 1336239854
-
- Long Term Care Pharmacy
- Collins, MS
- NPI 1962138818
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548288000000",
"number": "1114134285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 327",
"city": "COLLINS",
"state": "MS",
"postal_code": "394280327",
"telephone_number": "601-765-6817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 MAIN ST",
"city": "COLLINS",
"state": "MS",
"postal_code": "394280327",
"telephone_number": "601-765-6817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "JAMES",
"middle_name": "CLIFTON",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2019-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E06945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Collins, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.