Active NPI
Jennifer Denise Kelly, RPH
- Pharmacist
- Fort Smith, AR
National Provider Identifier
1144822263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD07236
- Practice address
- 2100 N 62ND St
Fort Smith, AR 72904-5163 - Phone
- (479) 782-0606
- Fax
- (479) 783-2206
- NPI assigned
- Nov 13, 2020
- Sex
- Female
- 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 | PD07236 | AR | Primary |
Addresses
Primary practice location
2100 N 62ND St
Fort Smith, AR 72904-5163
Mailing address
610 Jenny Wren St
Van Buren, AR 72956-2526
Phone (479) 806-6380
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 |
|---|---|---|---|
| PD07236 | AR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605225600000",
"number": "1144822263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 JENNY WREN ST",
"city": "VAN BUREN",
"state": "AR",
"postal_code": "729562526",
"telephone_number": "479-806-6380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 N 62ND ST",
"city": "FORT SMITH",
"state": "AR",
"postal_code": "729045163",
"telephone_number": "479-782-0606",
"fax_number": "479-783-2206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "JENNIFER",
"middle_name": "DENISE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-13",
"last_updated": "2020-11-13",
"certification_date": "2020-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD07236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Smith, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.