Active NPI
Kim Mary Mella, PHARM.D
- Pharmacist
- Tampa, FL
National Provider Identifier
1548633522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS43166
- Practice address
- 11637 Bristol Chase Dr
Tampa, FL 33626-3301 - Phone
- (727) 527-2769
- NPI assigned
- Nov 12, 2015
- Last updated
- Nov 12, 2015
- 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 | PS43166 | FL | Primary |
Addresses
Primary practice location
11637 Bristol Chase Dr
Tampa, FL 33626-3301
Mailing address
6900 34TH St N
Pinellas Park, FL 33781-6246
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS43166 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past | Accepting new patients |
Organizations & group practices 1
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": "1447286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447286400000",
"number": "1548633522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6900 34TH ST N",
"city": "PINELLAS PARK",
"state": "FL",
"postal_code": "337816246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11637 BRISTOL CHASE DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336263301",
"telephone_number": "727-527-2769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLA",
"first_name": "KIM",
"middle_name": "MARY",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-12",
"last_updated": "2015-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS43166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.