Active NPI
Neal N Kelly, RPH
- Pharmacist
- Lake Oswego, OR
National Provider Identifier
1285976704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0012232
- Practice address
- 664 3Rd St
Lake Oswego, OR 97034-2348 - Phone
- (503) 504-8554
- Fax
- (360) 213-2238
- NPI assigned
- Mar 22, 2013
- Sex
- Male
- 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 | RPH-0012232 | OR | Primary |
Addresses
Primary practice location
664 3Rd St
Lake Oswego, OR 97034-2348
Mailing address
664 3Rd St
Lake Oswego, OR 97034-2348
Phone (503) 504-8554
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RPH-0012232 | Other | OR | PHARMACIST LICENSE |
| RPH-0012232-P | Other | OR | PHARMACY PRECEPTOR LICENSE |
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 |
|---|---|---|---|
| RPH-0012232 | OR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367280000000",
"number": "1285976704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "664 3RD ST",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970342348",
"telephone_number": "503-504-8554",
"fax_number": "360-213-2238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "664 3RD ST",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970342348",
"telephone_number": "503-504-8554",
"fax_number": "360-213-2238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "NEAL",
"middle_name": "N",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-03-22",
"last_updated": "2013-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0012232",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "RPH-0012232",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY PRECEPTOR LICENSE",
"identifier": "RPH-0012232-P",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Oswego, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.