Active NPI
Korey A Kennelty, PHARMD, MS
- Pharmacist
- Madison, WI
National Provider Identifier
1538415435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15353-40
- Practice address
- 606 S Whitney Way
Madison, WI 53711-1035 - Phone
- (608) 274-1311
- NPI assigned
- Jul 28, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15353-40 | WI | Primary |
Addresses
Primary practice location
606 S Whitney Way
Madison, WI 53711-1035
Mailing address
6004 Dell Dr
Madison, WI 53718-8200
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
- Master of Science, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15353-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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.
-
- Pharmacy
- Madison, WI
- NPI 1912914805
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343433600000",
"number": "1538415435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6004 DELL DR",
"city": "MADISON",
"state": "WI",
"postal_code": "537188200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "606 S WHITNEY WAY",
"city": "MADISON",
"state": "WI",
"postal_code": "537111035",
"telephone_number": "608-274-1311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNELTY",
"first_name": "KOREY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PHARMD, MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-28",
"last_updated": "2012-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "15353-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.