Individual provider Active NPI

Kay Lynne Zietlow, RPH

  • Pharmacist
  • Shelbyville, IN
National Provider Identifier
1649394479
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26017222A Issued in IN
Practice address
1412 Miller Avenue
Shelbyville, IN 46176
Phone
(317) 421-2020
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 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 26017222A IN Primary

Addresses

Primary practice location

1412 Miller Avenue
Shelbyville, IN 46176

Mailing address

1412 Miller Avenue
Shelbyville, IN 46176

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
26017222AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Medworks Inc CurrentSince Sep 25, 2022 Accepting new patients
Medworks, Inc Current Accepting new patients

Locations

1412 Miller Ave
Shelbyville, IN 46176
Phone (317) 421-2020

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1649394479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 MILLER AVENUE",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "46176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 MILLER AVENUE",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "46176",
            "telephone_number": "317-421-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIETLOW",
        "first_name": "KAY",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26017222A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.