Individual provider Active NPI

Jasmine Kelly, PHARMD

  • Pharmacist
  • Tallahassee, FL
National Provider Identifier
1396487153
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
63862 Issued in FL
Practice address
2349 N Monroe St
Tallahassee, FL 32303-4733
Phone
(850) 385-7104
NPI assigned
Apr 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 63862 FL Primary

Addresses

Primary practice location

2349 N Monroe St
Tallahassee, FL 32303-4733

Mailing address

2349 N Monroe St
Tallahassee, FL 32303-4733

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
63862FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Apr 17, 2022 Accepting new patients
Walgreen Co PastSince Apr 17, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1396487153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2349 N MONROE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323034733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 N MONROE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323034733",
            "telephone_number": "850-385-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JASMINE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "63862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.