NPIMap

Individual provider Active NPI

Jacquelyn D Kelly, PHARMD

  • Pharmacist
  • Cambridge, MD
National Provider Identifier
1629946140
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15986 Issued in MD
Practice address
409 Race St
Cambridge, MD 21613-1835
Phone
(410) 228-3322
Fax
(410) 228-3666
NPI assigned
Oct 27, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15986 MD Primary

Addresses

Primary practice location

409 Race St
Cambridge, MD 21613-1835

Mailing address

409 Race St
Cambridge, MD 21613-1835
Phone (410) 228-3322

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

Practice roles

OrganizationSpecialtyStatusNew patients
Craig'S Drug Store, Inc. Current Accepting new patients
Craig'S Drug Store, Inc. Current Accepting new patients

Locations

409 Race St
Cambridge, MD 21613
Phone (410) 228-3322

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": "1761523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1629946140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 RACE ST",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131835",
            "telephone_number": "410-228-3322",
            "fax_number": "410-228-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 RACE ST",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131835",
            "telephone_number": "410-228-3322",
            "fax_number": "410-228-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JACQUELYN",
        "middle_name": "D",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-27",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "15986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.