Active NPI
Kriston Ellis
- Pharmacist
- Beckley, WV
National Provider Identifier
1194188037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 6921
- Practice address
- 301 Beckley PLZ
Beckley, WV 25801-2215 - Phone
- (304) 252-8522
- Fax
- (847) 396-3211
- NPI assigned
- Mar 29, 2016
- 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 | 6921 | WV | Primary |
Addresses
Primary practice location
301 Beckley PLZ
Beckley, WV 25801-2215
Mailing address
301 Beckley PLZ
Beckley, WV 25801-2215
Phone (304) 252-8522
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 |
|---|---|---|---|
| 6921 | WV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Pharmacy & Wellness Inc | Current | 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.
-
- Community/Retail Pharmacy
- Beckley, WV
- NPI 1669026621
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459209600000",
"number": "1194188037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 BECKLEY PLZ",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258012215",
"telephone_number": "304-252-8522",
"fax_number": "847-396-3211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 BECKLEY PLZ",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258012215",
"telephone_number": "304-252-8522",
"fax_number": "847-396-3211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "KRISTON",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-29",
"last_updated": "2016-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "6921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beckley, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.