Individual provider Active NPI

Kelsey Marie Bauer

  • Pharmacist
  • Berwyn, PA
National Provider Identifier
1689157067
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP452491 Issued in PA
Practice address
550 Lancaster Ave
Berwyn, PA 19312-1635
Phone
(610) 644-7192
NPI assigned
Sep 11, 2018
Last updated
Nov 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP452491 PA Primary

Addresses

Primary practice location

550 Lancaster Ave
Berwyn, PA 19312-1635

Mailing address

550 Lancaster Ave
Berwyn, PA 19312-1635

Other practice location 1

5040 City Line Ave
Philadelphia, PA 19131-1435
Phone (215) 877-2116

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

State licenses

LicenseStateTypeSpecialty
RP452491PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania CVS Pharmacy, L.L.C. PastSince Nov 22, 2020 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": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1689157067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 LANCASTER AVE",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 LANCASTER AVE",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121635",
            "telephone_number": "610-644-7192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5040 City Line Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191311435",
            "country_code": "US",
            "telephone_number": "215-877-2116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUER",
        "first_name": "KELSEY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP452491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.