Samantha Ann Kelly, CPHT

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

281242 Issued in TX

Practice address

1812 Centre Creek Dr Ste 115
Austin, TX 78754-5133

Phone

(512) 579-0184

NPI assigned

Jan 2, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1255970703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 WELLS BRANCH PKWY APT 1614",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787286918",
            "telephone_number": "318-655-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 CENTRE CREEK DR STE 115",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787545133",
            "telephone_number": "512-579-0184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "credential": "CPHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "TX",
            "license": "281242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keontaye Kelly
• Kiley Kelly, DC, MSAC
• Melissa Kelly, RD
• Monica Jurado Kelly, LCSW
• Nancy W. Kelly, PH.D., LCSW
• Scott Douglas Kelly, M.D.
• Melanie Kelner, LMFT, LPC
• John Kavin Kelp, DDS
• Kelsey Balaban
• Kelsey Lee Somatic Psychotherapy PLLC

• Pharmacy Technician in Austin, TX
• Providers in Austin, TX by specialty
• Pharmacy Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.