Active NPI
Chermaine Kelly
- Student in an Organized Health Care Education/Training Program
- Terrytown, LA
National Provider Identifier
1164848123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 46354
- Practice address
- 2831 Belle Chasse Hwy
Terrytown, LA 70056-7132 - Phone
- (504) 394-0626
- NPI assigned
- Mar 13, 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 46354 | LA | Primary |
Addresses
Primary practice location
2831 Belle Chasse Hwy
Terrytown, LA 70056-7132
Mailing address
2831 Belle Chasse Hwy
Terrytown, LA 70056-7132
Phone (504) 394-0626
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46354 | LA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Louisiana CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418169600000",
"number": "1164848123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2831 BELLE CHASSE HWY",
"city": "TERRYTOWN",
"state": "LA",
"postal_code": "700567132",
"telephone_number": "504-394-0626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2831 BELLE CHASSE HWY",
"city": "TERRYTOWN",
"state": "LA",
"postal_code": "700567132",
"telephone_number": "504-394-0626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "CHERMAINE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-13",
"last_updated": "2014-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "LA",
"license": "46354",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Terrytown, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.