Active NPI
Kaley Diane Vance, RPH
- Pharmacist
- Mount Gay, WV
National Provider Identifier
1245674084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0008582
- Practice address
- 25 Holden Rd
Mount Gay, WV 25637 - Phone
- (304) 239-2380
- Fax
- (304) 239-2384
- NPI assigned
- Apr 23, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | 0008582 | WV | Primary |
Addresses
Primary practice location
25 Holden Rd
Mount Gay, WV 25637
Mailing address
PO Box 452
Pecks Mill, WV 25547-0452
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 |
|---|---|---|---|
| 0008582 | WV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Limited Partnership I | 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.
-
dba Kroger Pharmacy #473
- Community/Retail Pharmacy
- Newport, KY
- NPI 1104791078
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778803200000",
"number": "1245674084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 452",
"city": "PECKS MILL",
"state": "WV",
"postal_code": "255470452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 HOLDEN RD",
"city": "MOUNT GAY",
"state": "WV",
"postal_code": "25637",
"telephone_number": "304-239-2380",
"fax_number": "304-239-2384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANCE",
"first_name": "KALEY",
"middle_name": "DIANE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-23",
"last_updated": "2026-05-15",
"certification_date": "2026-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "0008582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Gay, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.