Active NPI
Lawrence Gerard Kelly
- Pharmacist
- Cozad, NE
National Provider Identifier
1316438898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 10201
- Practice address
- 2101 O St Apt 209
Cozad, NE 69130-1077 - Phone
- (402) 699-8440
- NPI assigned
- May 21, 2018
- 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 | 10201 | NE | Primary |
Addresses
Primary practice location
2101 O St Apt 209
Cozad, NE 69130-1077
Mailing address
2101 O St Apt 209
Cozad, NE 69130-1077
Phone (402) 699-8440
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10201 | Other | NE | PHARMACY 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10201 | NE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1316438898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 O ST APT 209",
"city": "COZAD",
"state": "NE",
"postal_code": "691301077",
"telephone_number": "402-699-8440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 O ST APT 209",
"city": "COZAD",
"state": "NE",
"postal_code": "691301077",
"telephone_number": "402-699-8440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "LAWRENCE",
"middle_name": "GERARD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-21",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "10201",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE",
"identifier": "10201",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cozad, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.