Active NPI
Kelly Jeanine Harrell, PD
- Pharmacist
- Cabot, AR
National Provider Identifier
1912499583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PD07555
- Practice address
- 25 Bull Run Loop
Cabot, AR 72023-9401 - Phone
- (501) 259-0564
- NPI assigned
- May 30, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | PD07555 | AR | Primary |
Addresses
Primary practice location
25 Bull Run Loop
Cabot, AR 72023-9401
Mailing address
25 Bull Run Loop
Cabot, AR 72023-9401
Phone (501) 259-0564
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 |
|---|---|---|---|
| PD07555 | AR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527638400000",
"number": "1912499583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 BULL RUN LOOP",
"city": "CABOT",
"state": "AR",
"postal_code": "720239401",
"telephone_number": "501-259-0564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 BULL RUN LOOP",
"city": "CABOT",
"state": "AR",
"postal_code": "720239401",
"telephone_number": "501-259-0564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "KELLY",
"middle_name": "JEANINE",
"credential": "PD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-30",
"last_updated": "2018-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AR",
"license": "PD07555",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cabot, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.