Jade Kelley, PHARMD, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

125246 Issued in MN

Practice address

101 Main Ave N
Park Rapids, MN 56470-1511

Phone

(218) 732-3342

NPI assigned

Jul 29, 2021

Last updated

Jul 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

State licenses

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1891468443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 NORTHERN CEDAR AVE NW APT 111",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566012885",
            "telephone_number": "218-686-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAIN AVE N",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564701511",
            "telephone_number": "218-732-3342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JADE",
        "name_prefix": "Dr.",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "125246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Don Josefson, MA, LADC
• Sriveer Kaasam, M.D.
• Anna C Kanani
• Rae Keashly, MD
• Jennifer M Keller, O.D.
• Mariah Rose Kemmer
• Laura Kempnich, MSW, LGSW
• Genevieve A Keranen, CDE
• Ki Senior Living of Park Rapids, LLC (Crystal Brook Senior Living)
• Jessica J Kimball

• Pharmacist in Park Rapids, MN
• Providers in Park Rapids, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.

Verify at the official NPI Registry.