Individual provider Active NPI

Kelly Ann Marks, PHARMACIST

  • Ambulatory Care Pharmacist
  • New Bedford, MA
National Provider Identifier
1386538569
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
20122 Issued in MA
Practice address
1103 Kempton St
New Bedford, MA 02740-1530
Phone
(508) 990-3765
NPI assigned
Jun 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X 3169 RI
Ambulatory Care Pharmacist 1835P2201X 20122 MA Primary

Addresses

Primary practice location

1103 Kempton St
New Bedford, MA 02740-1530

Mailing address

24 Highland Rd
Tiverton, RI 02878-4410
Phone (401) 473-4239

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

LicenseStateTypeSpecialty
20122MAMDDentist
3169RIMDAmbulatory Care Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Jun 8, 2025 Accepting new patients
Walgreen Co PastSince Jun 8, 2025 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1748995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1386538569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HIGHLAND RD",
            "city": "TIVERTON",
            "state": "RI",
            "postal_code": "028784410",
            "telephone_number": "401-473-4239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 KEMPTON ST",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027401530",
            "telephone_number": "508-990-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-04",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "RI",
            "license": "3169",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "MA",
            "license": "20122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bedford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.