Individual provider Active NPI

Kayla Cheyenne Melton

  • Pharmacy Technician
  • Bastrop, TX
National Provider Identifier
1710654090
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
259112 Issued in TX
Practice address
104 N Hasler Blvd
Bastrop, TX 78602-3740
Phone
(512) 321-1033
Fax
(512) 332-0422
NPI assigned
Aug 25, 2021
Last updated
Aug 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 259112 TX Primary

Addresses

Primary practice location

104 N Hasler Blvd
Bastrop, TX 78602-3740

Mailing address

104 N Hasler Blvd
Bastrop, TX 78602-3740
Phone (512) 321-1033

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
259112TXMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
H-E-B, LP PastSince Aug 29, 2021 Accepting new patients
H-E-B, LP PastSince Aug 29, 2021 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, 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": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1710654090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N HASLER BLVD",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786023740",
            "telephone_number": "512-321-1033",
            "fax_number": "512-332-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N HASLER BLVD",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786023740",
            "telephone_number": "512-321-1033",
            "fax_number": "512-332-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELTON",
        "first_name": "KAYLA",
        "middle_name": "CHEYENNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "TX",
            "license": "259112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.