Individual provider Active NPI

Thomas Michael Kelly Jr., R.PH., B.SC.

  • Pharmacotherapy Pharmacist
  • Forked River, NJ
National Provider Identifier
1215958723
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
28RI01600600 Issued in NJ
Practice address
528 West Lacey Road
Forked River, NJ 08731
Phone
(609) 242-1400
Fax
(609) 242-1496
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI01600600 NJ
Pharmacotherapy Pharmacist 1835P1200X 28RI01600600 NJ Primary

Addresses

Primary practice location

528 West Lacey Road
Forked River, NJ 08731

Mailing address

133 5TH St
Beach Haven, NJ 08008-1937
Phone (609) 492-2574

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

LicenseStateTypeSpecialty
28RI01600600NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Handicapable, Inc. Current Accepting new patients
Handicapable, Inc. Current Accepting new patients

Locations

528 Lacey Rd
Forked River, NJ 08731
Phone (609) 242-1400

Organizations & group practices 2

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1215958723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 5TH ST",
            "city": "BEACH HAVEN",
            "state": "NJ",
            "postal_code": "080081937",
            "telephone_number": "609-492-2574",
            "fax_number": "609-242-1496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 WEST LACEY ROAD",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "08731",
            "telephone_number": "609-242-1400",
            "fax_number": "609-242-1496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "THOMAS",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "R.PH., B.SC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI01600600",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "NJ",
            "license": "28RI01600600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forked River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.