Active NPI
Lauren Kelly
- Pharmacist
- Walden, NY
National Provider Identifier
1841896495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 062080
- Practice address
- 78 Oak St
Walden, NY 12586-1076 - Phone
- (845) 778-1388
- NPI assigned
- Dec 9, 2020
- Last updated
- Apr 5, 2021
- 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 | 062080 | NY | Primary |
Addresses
Primary practice location
78 Oak St
Walden, NY 12586-1076
Mailing address
163 Rabbit Run Rd
Clintondale, NY 12515-5006
Phone (845) 633-3316
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 |
|---|---|---|---|
| 062080 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thruway Pharmacy, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pharmacy
- Walden, NY
- NPI 1699748350
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617580800000",
"number": "1841896495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "163 RABBIT RUN RD",
"city": "CLINTONDALE",
"state": "NY",
"postal_code": "125155006",
"telephone_number": "845-633-3316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "78 OAK ST",
"city": "WALDEN",
"state": "NY",
"postal_code": "125861076",
"telephone_number": "845-778-1388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-09",
"last_updated": "2021-04-05",
"certification_date": "2021-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "062080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walden, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.