Individual provider Active NPI

Jennifer Joyce Kerley, RPH

  • Pharmacist
  • Evans Mills, NY
National Provider Identifier
1134442379
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
047892 Issued in NY
Practice address
25737 US Route 11
Evans Mills, NY 13637
Phone
(315) 629-2402
Fax
(315) 629-4305
NPI assigned
Mar 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 047892 NY Primary

Addresses

Primary practice location

25737 US Route 11
Evans Mills, NY 13637

Mailing address

PO Box 294
Three Mile Bay, NY 13693-0294
Phone (315) 649-2269

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

LicenseStateTypeSpecialty
047892NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267488000000",
    "number": "1134442379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 294",
            "city": "THREE MILE BAY",
            "state": "NY",
            "postal_code": "136930294",
            "telephone_number": "315-649-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25737 US ROUTE 11",
            "city": "EVANS MILLS",
            "state": "NY",
            "postal_code": "13637",
            "telephone_number": "315-629-2402",
            "fax_number": "315-629-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERLEY",
        "first_name": "JENNIFER",
        "middle_name": "JOYCE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-02",
        "last_updated": "2010-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "047892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans Mills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; 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.