Active NPI
Amy Kristine Kelley, RPH
- Pharmacist
- Clovis, NM
National Provider Identifier
1154655512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5544
- Practice address
- 3728 N Prince St
Clovis, NM 88101-9744 - Phone
- (575) 769-2389
- NPI assigned
- Oct 1, 2009
- Last updated
- Feb 23, 2014
- 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 | 5544 | NM | Primary |
Addresses
Primary practice location
3728 N Prince St
Clovis, NM 88101-9744
Mailing address
2320 Fairway Ter
Clovis, NM 88101-2724
Phone (575) 763-4161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5544 | Other | NM | NEW MEXICO BOARD OF PHARMACY LICENSE NUMBER |
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 |
|---|---|---|---|
| 5544 | NM | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393113600000",
"number": "1154655512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2320 FAIRWAY TER",
"city": "CLOVIS",
"state": "NM",
"postal_code": "881012724",
"telephone_number": "575-763-4161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3728 N PRINCE ST",
"city": "CLOVIS",
"state": "NM",
"postal_code": "881019744",
"telephone_number": "575-769-2389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "AMY",
"middle_name": "KRISTINE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-01",
"last_updated": "2014-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "5544",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW MEXICO BOARD OF PHARMACY LICENSE NUMBER",
"identifier": "5544",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clovis, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.