Active NPI
Ketlie Andre, PHARMD
- Pharmacist
- Riviera Beach, FL
National Provider Identifier
1649554619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS41913
- Practice address
- 2501 Broadway
Riviera Beach, FL 33404-4534 - Phone
- (561) 848-6464
- NPI assigned
- Oct 7, 2011
- Sex
- Female
- Sole proprietor
- No
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 | PS41913 | FL | Primary |
Addresses
Primary practice location
2501 Broadway
Riviera Beach, FL 33404-4534
Mailing address
1700 N Congress Ave Apt A405
West Palm Beach, FL 33401-1667
Phone (561) 688-9930
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 |
|---|---|---|---|
| PS41913 | FL | 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
- Riviera Beach, FL
- NPI 1427064914
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317945600000",
"number": "1649554619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 N CONGRESS AVE APT A405",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334011667",
"telephone_number": "561-688-9930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 BROADWAY",
"city": "RIVIERA BEACH",
"state": "FL",
"postal_code": "334044534",
"telephone_number": "561-848-6464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDRE",
"first_name": "KETLIE",
"name_prefix": "Mrs.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-07",
"last_updated": "2011-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS41913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riviera Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.