Active NPI
Kenneth Lee Kelps
- Pharmacist
- Ravenswood, WV
National Provider Identifier
1285926717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP0003908
- Practice address
- 406 Washington St
Ravenswood, WV 26164-1706 - Phone
- (304) 273-4496
- Fax
- (304) 273-9426
- NPI assigned
- May 2, 2011
- Sex
- Male
- 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 | RP0003908 | WV | Primary |
Addresses
Primary practice location
406 Washington St
Ravenswood, WV 26164-1706
Mailing address
406 Washington St
Ravenswood, WV 26164-1706
Phone (304) 273-4496
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RP0003908 | Other | WV | WEST VIRGINIA BOARD OF PHARMACY |
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 |
|---|---|---|---|
| RP0003908 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304294400000",
"number": "1285926717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "406 WASHINGTON ST",
"city": "RAVENSWOOD",
"state": "WV",
"postal_code": "261641706",
"telephone_number": "304-273-4496",
"fax_number": "304-273-9426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "406 WASHINGTON ST",
"city": "RAVENSWOOD",
"state": "WV",
"postal_code": "261641706",
"telephone_number": "304-273-4496",
"fax_number": "304-273-9426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELPS",
"first_name": "KENNETH",
"middle_name": "LEE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-05-02",
"last_updated": "2011-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0003908",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WEST VIRGINIA BOARD OF PHARMACY",
"identifier": "RP0003908",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ravenswood, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.