Active NPI
Daniel T Kelly
- Pharmacist
- North Vernon, IN
National Provider Identifier
1851995922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 26024018A
- Practice address
- 10 N State St
North Vernon, IN 47265-1722 - Phone
- (812) 346-1200
- NPI assigned
- Nov 29, 2020
- Last updated
- Nov 29, 2020
- Sex
- Male
- 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 | 26024018A | IN | Primary |
Addresses
Primary practice location
10 N State St
North Vernon, IN 47265-1722
Mailing address
483 S Norris Ave
North Vernon, IN 47265-7118
Phone (812) 701-4237
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 |
|---|---|---|---|
| 26024018A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hook-Superx LLC | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606608000000",
"number": "1851995922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "483 S NORRIS AVE",
"city": "NORTH VERNON",
"state": "IN",
"postal_code": "472657118",
"telephone_number": "812-701-4237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 N STATE ST",
"city": "NORTH VERNON",
"state": "IN",
"postal_code": "472651722",
"telephone_number": "812-346-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "DANIEL",
"middle_name": "T",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-29",
"last_updated": "2020-11-29",
"certification_date": "2020-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "26024018A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Vernon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.