NPIMap

Individual provider Active NPI

Kelly Butler, PHARMD

  • Pharmacist
  • Jasper, AL
National Provider Identifier
1174245658
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14258 Issued in AL
Practice address
100 N Airport Rd
Jasper, AL 35504-7520
Phone
(205) 221-3150
NPI assigned
Sep 13, 2022
Last updated
Sep 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 14258 AL Primary

Addresses

Primary practice location

100 N Airport Rd
Jasper, AL 35504-7520

Mailing address

1401 1St Ave E
Jasper, AL 35501-4732

Electronic endpoints 6

TypeEndpointUseAffiliation
Other URL walgreens.com Walgreens
Other URL walgreens walgreens
Other URL walgreens.com Walgreens
Other URL walgreens walgreens
Other URL walgreens walgreens
Other URL walgreens.com Walgreens

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
14258ALMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co CurrentSince Sep 20, 2022 Accepting new patients
Walgreen Co PastSince Mar 27, 2022 Accepting new patients
Walgreen Co PastSince Sep 20, 2022 Accepting new patients

Locations

100 N Airport Rd
Jasper, AL 35504
Phone (205) 221-3150

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1174245658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 1ST AVE E",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355014732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N AIRPORT RD",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355047520",
            "telephone_number": "205-221-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "KELLY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-13",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "14258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "walgreens.com",
            "affiliation": "Y",
            "endpointDescription": "website",
            "affiliationName": "Walgreens",
            "address_1": "879 Highway 78",
            "city": "Sumiton",
            "state": "AL",
            "country_code": "US",
            "postal_code": "351483416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "walgreens",
            "affiliation": "Y",
            "affiliationName": "walgreens",
            "address_1": "879 Highway 78",
            "city": "Sumiton",
            "state": "AL",
            "country_code": "US",
            "postal_code": "351483416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "walgreens.com",
            "affiliation": "Y",
            "endpointDescription": "website",
            "affiliationName": "Walgreens",
            "address_1": "879 Highway 78",
            "city": "Sumiton",
            "state": "AL",
            "country_code": "US",
            "postal_code": "351483416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "walgreens",
            "affiliation": "Y",
            "affiliationName": "walgreens",
            "address_1": "879 Highway 78",
            "city": "Sumiton",
            "state": "AL",
            "country_code": "US",
            "postal_code": "351483416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "walgreens",
            "affiliation": "Y",
            "affiliationName": "walgreens",
            "address_1": "879 Highway 78",
            "city": "Sumiton",
            "state": "AL",
            "country_code": "US",
            "postal_code": "351483416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "walgreens.com",
            "affiliation": "Y",
            "endpointDescription": "website",
            "affiliationName": "Walgreens",
            "address_1": "879 Highway 78",
            "city": "Sumiton",
            "state": "AL",
            "country_code": "US",
            "postal_code": "351483416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jasper, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.