Individual provider Active NPI

Jessica Rhyan Kelley, PHARM. D.

  • Pharmacist
  • Fort Lawn, SC
National Provider Identifier
1366944910
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
37551 Issued in SC
Practice address
1207 Mount Vernon Rd
Fort Lawn, SC 29714-8696
Phone
(423) 258-1981
NPI assigned
Feb 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 37551 SC Primary

Addresses

Primary practice location

1207 Mount Vernon Rd
Fort Lawn, SC 29714-8696

Mailing address

1207 Mount Vernon Rd
Fort Lawn, SC 29714-8696
Phone (423) 258-1981

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

LicenseStateTypeSpecialty
37551SCMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1366944910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 MOUNT VERNON RD",
            "city": "FORT LAWN",
            "state": "SC",
            "postal_code": "297148696",
            "telephone_number": "423-258-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 MOUNT VERNON RD",
            "city": "FORT LAWN",
            "state": "SC",
            "postal_code": "297148696",
            "telephone_number": "423-258-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JESSICA",
        "middle_name": "RHYAN",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "37551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lawn, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.

Verify at the official NPI Registry.