Active NPI
Kelly Caulk
- Pharmacist
- Baton Rouge, LA
National Provider Identifier
1306459870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.023562
- Practice address
- 15128 Airline Hwy
Baton Rouge, LA 70817-7307 - Phone
- (225) 751-4415
- NPI assigned
- Aug 25, 2020
- Last updated
- Aug 25, 2020
- 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 | PST.023562 | LA | Primary |
Addresses
Primary practice location
15128 Airline Hwy
Baton Rouge, LA 70817-7307
Mailing address
2950 College Dive
Baton Rouge, LA 70808
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | EPS |
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 |
|---|---|---|---|
| PST.023562 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albertsons LLC | Past | Accepting new patients | |
| Albertsons LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Albertsons Pharmacy #3747
- Community/Retail Pharmacy
- Baton Rouge, LA
- NPI 1891735262
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598313600000",
"number": "1306459870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2950 COLLEGE DIVE",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "70808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15128 AIRLINE HWY",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708177307",
"telephone_number": "225-751-4415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAULK",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-25",
"last_updated": "2020-08-25",
"certification_date": "2020-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.023562",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "EPS",
"affiliation": "N",
"address_1": "15128 Airline Hwy",
"city": "Baton Rouge",
"state": "LA",
"country_code": "US",
"postal_code": "708177307",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.