Individual provider Active NPI

James Taylor Kelley, PHARMD

  • Pharmacist
  • Blackfoot, ID
National Provider Identifier
1376875294
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P5920 Issued in ID
Practice address
565 Jensen Grove Dr
Blackfoot, ID 83221-1682
Phone
(208) 785-0277
Fax
(208) 785-0388
NPI assigned
Feb 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P5920 ID Primary

Addresses

Primary practice location

565 Jensen Grove Dr
Blackfoot, ID 83221-1682

Mailing address

565 Jensen Grove Dr
Blackfoot, ID 83221-1682
Phone (208) 785-0277

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
P5920IDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1376875294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 JENSEN GROVE DR",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211682",
            "telephone_number": "208-785-0277",
            "fax_number": "208-785-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 JENSEN GROVE DR",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211682",
            "telephone_number": "208-785-0277",
            "fax_number": "208-785-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JAMES",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-02",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P5920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackfoot, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.