Individual provider Active NPI

Kellie Busby, PHARMD, BCPP

  • Pharmacist
  • Chandler, AZ
National Provider Identifier
1902213101
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S020576 Issued in AZ
Practice address
1623 N Apache Dr
Chandler, AZ 85224-8620
Phone
(480) 477-4468
NPI assigned
Jul 20, 2014
Last updated
Aug 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S020576 AZ Primary
Psychiatric Pharmacist 1835P1300X S020576 AZ

Addresses

Primary practice location

1623 N Apache Dr
Chandler, AZ 85224-8620

Mailing address

1623 N Apache Dr
Chandler, AZ 85224-8620
Phone (480) 477-4468

Other practice location 1

6116 E Arbor Ave Ste 106
Mesa, AZ 85206-6103
Phone (480) 750-1635

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

LicenseStateTypeSpecialty
S020576AZMDPsychiatric Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1405814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1902213101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 N APACHE DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852248620",
            "telephone_number": "480-477-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 N APACHE DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852248620",
            "telephone_number": "480-477-4468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6116 E Arbor Ave Ste 106",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852066103",
            "country_code": "US",
            "telephone_number": "480-750-1635",
            "fax_number": "623-444-3198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSBY",
        "first_name": "KELLIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD, BCPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-20",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S020576",
            "primary": true
        },
        {
            "code": "1835P1300X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Psychiatric",
            "state": "AZ",
            "license": "S020576",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.