Individual provider Active NPI

Amanda Kerr Kelley, PHARM.D.

  • Pharmacist
  • Laurens, SC
National Provider Identifier
1790068377
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
22014 Issued in NC
Practice address
922 E Mainst
Pharmacy
Laurens, SC 29360-3616
Phone
(864) 682-8104
Fax
(864) 683-5760
NPI assigned
Sep 21, 2011
Last updated
Apr 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 22014 NC Primary
Pharmacist 183500000X RP447604 PA
Pharmacist 183500000X SC35905 SC

Addresses

Primary practice location

922 E Mainst
Pharmacy
Laurens, SC 29360-3616

Mailing address

922 E Mainst
Laurens, SC 29360-3616
Phone (864) 682-8104

Other names 1

  • Amanda R Kerr Former name

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

LicenseStateTypeSpecialty
22014NCMDPharmacist
RP447604PAMDPharmacist
SC35905SCMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1790068377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 E MAINST",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293603616",
            "telephone_number": "864-682-8104",
            "fax_number": "864-683-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 E MAINST",
            "address_2": "PHARMACY",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293603616",
            "telephone_number": "864-682-8104",
            "fax_number": "864-683-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "AMANDA",
        "middle_name": "KERR",
        "name_prefix": "Mrs.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "22014",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP447604",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "SC35905",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "KERR",
            "middle_name": "R",
            "credential": "PHARM.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Laurens, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.