Sue Ellen Kelley, R. PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

11237 Issued in AL

Practice address

112 S 4TH Ave
Hartford, AL 36344-1615

Phone

(334) 588-2442

Fax

(334) 588-2447

NPI assigned

Mar 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hartford Pharmacy LLC

  • Community/Retail Pharmacy
  • Hartford, AL
  • NPI 1851634109
  NPD (past)

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1376120188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S 4TH AVE",
            "city": "HARTFORD",
            "state": "AL",
            "postal_code": "363441615",
            "telephone_number": "334-588-2442",
            "fax_number": "334-588-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S 4TH AVE",
            "city": "HARTFORD",
            "state": "AL",
            "postal_code": "363441615",
            "telephone_number": "334-588-2442",
            "fax_number": "334-588-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "SUE",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "R. PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "11237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HARTFORD",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "112 S 4th Ave",
            "city": "Hartford",
            "state": "AL",
            "country_code": "US",
            "postal_code": "363441615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hartford Pharmacy LLC
• Hartford Rehab and Welness, LLC
• Beate Holmes, M.S. LPC
• Sandra Deann Hunter
• Sabrena Michelle Jerkins
• Richard Thomas Kennedy, M.D.
• Sunny D Knowles, PTA
• Christina E Lynch
• Jacquelyn Jay Paul-Stevens, MS, LPC, MAC
• Kara Ann Pippin

• Pharmacist in Hartford, AL
• Providers in Hartford, AL by specialty
• Pharmacist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.