Individual provider Active NPI

Kayla Lueellen Anthony, PHARMD

  • Pharmacist
  • Melbourne, FL
National Provider Identifier
1528606969
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS60333 Issued in FL
Practice address
2750 W New Haven Ave
Melbourne, FL 32904-3706
Phone
(321) 722-9262
NPI assigned
Dec 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS60333 FL Primary

Addresses

Primary practice location

2750 W New Haven Ave
Melbourne, FL 32904-3706

Mailing address

2750 W New Haven Ave
Melbourne, FL 32904-3706
Phone (321) 722-9262

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kwaymye@g.clemson.edu

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
PS60333FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1528606969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 W NEW HAVEN AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329043706",
            "telephone_number": "321-722-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 W NEW HAVEN AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329043706",
            "telephone_number": "321-722-9262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "KAYLA",
        "middle_name": "LUEELLEN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-17",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS60333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwaymye@g.clemson.edu",
            "affiliation": "N",
            "address_1": "2750 W New Haven Ave",
            "city": "Melbourne",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329043706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.