Active NPI
Courtney W Kelly, PHARM D.
- Pharmacist
- Fairhaven, MA
National Provider Identifier
1295081933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH233545
- Practice address
- 132 Alden Rd
Fairhaven, MA 02719-4721 - Phone
- (508) 998-8000
- Fax
- (508) 998-1136
- NPI assigned
- Jul 31, 2012
- Sex
- Female
- 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 | PH233545 | MA | Primary |
Addresses
Primary practice location
132 Alden Rd
Fairhaven, MA 02719-4721
Mailing address
132 Alden Rd
Fairhaven, MA 02719-4721
Phone (508) 998-8000
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH233545 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343692800000",
"number": "1295081933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 ALDEN RD",
"city": "FAIRHAVEN",
"state": "MA",
"postal_code": "027194721",
"telephone_number": "508-998-8000",
"fax_number": "508-998-1136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 ALDEN RD",
"city": "FAIRHAVEN",
"state": "MA",
"postal_code": "027194721",
"telephone_number": "508-998-8000",
"fax_number": "508-998-1136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "COURTNEY",
"middle_name": "W",
"credential": "PHARM D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-31",
"last_updated": "2012-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH233545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairhaven, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.