Individual provider Active NPI

Kelly U Okpoko, PHARM.D.

  • Pharmacist
  • Plano, TX
National Provider Identifier
1124622469
Registry record updated Nov 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
53888 Issued in TX
Practice address
3513 E Park Blvd
Plano, TX 75074-3112
Phone
(469) 304-3148
NPI assigned
Nov 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 53888 TX Primary

Addresses

Primary practice location

3513 E Park Blvd
Plano, TX 75074-3112

Mailing address

3513 E Park Blvd
Plano, TX 75074-3112
Phone (469) 304-3148

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
53888TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1606435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606435200000",
    "number": "1124622469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 E PARK BLVD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750743112",
            "telephone_number": "469-304-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3513 E PARK BLVD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750743112",
            "telephone_number": "469-304-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKPOKO",
        "first_name": "KELLY",
        "middle_name": "U",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-27",
        "last_updated": "2020-11-27",
        "certification_date": "2020-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "53888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2020; 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.