Active NPI
Gretchen Mary Kelly, PHARM.D
- Pharmacist
- Ithaca, NY
National Provider Identifier
1841568979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 056500
- Practice address
- 135 Fairgrounds Memorial Pkwy
Ithaca Store#5240
Ithaca, NY 14850-5362 - Phone
- (607) 277-8126
- NPI assigned
- Dec 3, 2011
- 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 | 056500 | NY | Primary |
Addresses
Primary practice location
135 Fairgrounds Memorial Pkwy
Ithaca Store#5240
Ithaca, NY 14850-5362
Mailing address
135 Fairgrounds Memorial Pkwy
Ithaca Store#5240
Ithaca, NY 14850-5362
Phone (607) 277-8126
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 |
|---|---|---|---|
| 056500 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391817600000",
"number": "1841568979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135 FAIRGROUNDS MEMORIAL PKWY",
"address_2": "ITHACA STORE#5240",
"city": "ITHACA",
"state": "NY",
"postal_code": "148505362",
"telephone_number": "607-277-8126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 FAIRGROUNDS MEMORIAL PKWY",
"address_2": "ITHACA STORE#5240",
"city": "ITHACA",
"state": "NY",
"postal_code": "148505362",
"telephone_number": "607-277-8126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "GRETCHEN",
"middle_name": "MARY",
"name_prefix": "Ms.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-03",
"last_updated": "2014-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "056500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.