Active NPI
Kelly B Richeal
- Pharmacist
- Little Falls, MN
National Provider Identifier
1720413867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 121460
- Practice address
- 1023 1St Ave NE
Little Falls, MN 56345-3336 - Phone
- (320) 632-1639
- NPI assigned
- Sep 9, 2013
- 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 | 121460 | MN | Primary |
Addresses
Primary practice location
1023 1St Ave NE
Little Falls, MN 56345-3336
Mailing address
5505 Knollwood Dr
Saint Cloud, MN 56303-4682
Phone (563) 357-9224
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
| License | State | Type | Specialty |
|---|---|---|---|
| 121460 | MN | 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
- Little Falls, MN
- NPI 1730327982
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378684800000",
"number": "1720413867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5505 KNOLLWOOD DR",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563034682",
"telephone_number": "563-357-9224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1023 1ST AVE NE",
"city": "LITTLE FALLS",
"state": "MN",
"postal_code": "563453336",
"telephone_number": "320-632-1639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHEAL",
"first_name": "KELLY",
"middle_name": "B",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-09",
"last_updated": "2013-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "121460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Falls, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.