Active NPI
Kelli Marshall, PHARMD
- Counselor
- Kingsport, TN
National Provider Identifier
1811590771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 37687
- Practice address
- 4400 W Stone Dr
Kingsport, TN 37660-1051 - Phone
- (423) 247-3176
- NPI assigned
- Nov 20, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 37687 | TN | Primary |
Addresses
Primary practice location
4400 W Stone Dr
Kingsport, TN 37660-1051
Mailing address
4400 W Stone Dr
Kingsport, TN 37660-1051
Phone (423) 247-3176
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00000000000 | Other | TN | NON |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Kelli.marshall@cvshealth.com | Direct |
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 |
|---|---|---|---|
| 37687 | TN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tennessee CVS Pharmacy LLC | Past | Accepting new patients | |
| Tennessee CVS Pharmacy, L.L.C. | Past | Accepting new patients |
Interoperability endpoints
- kelli.marshall@cvshealth.com
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605830400000",
"number": "1811590771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 W STONE DR",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376601051",
"telephone_number": "423-247-3176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 W STONE DR",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376601051",
"telephone_number": "423-247-3176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "KELLI",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-20",
"last_updated": "2020-11-20",
"certification_date": "2020-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TN",
"license": "37687",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NON",
"identifier": "00000000000",
"state": "TN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Kelli.marshall@cvshealth.com",
"affiliation": "N",
"endpointDescription": "Cvs",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "4400 W Stone Dr",
"city": "Kingsport",
"state": "TN",
"country_code": "US",
"postal_code": "376601051",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Kingsport, TN
- Marcum's Pharmacy, Inc
- Marcum's Pharmacy, Inc (Marcum's SafePak Plus)
- Madison Emily Markey, PA-C
- Amy L Marlow, MD
- James Ivan Marshall, M.A.
- Phillip Edward Marshall, D.D.S.
- Martin Dentistry PC
- Martin Dentistry PC (Martin Dentistry of Colonial Heights)
- Ashton Martin, RN
- Christopher George Martin, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.