Active NPI
Birdie Mae Kelley, RPH
- Pharmacist
- Missouri City, TX
National Provider Identifier
1922336494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28366
- Practice address
- 3403 Texas Pkwy
Missouri City, TX 77489-5202 - Phone
- (281) 438-3557
- Fax
- (281) 438-7820
- NPI assigned
- Nov 22, 2009
- 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 | 28366 | TX | Primary |
Addresses
Primary practice location
3403 Texas Pkwy
Missouri City, TX 77489-5202
Mailing address
3403 Texas Pkwy
Missouri City, TX 77489-5202
Phone (281) 438-3557
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28366 | Other | TX | TEXAS STATE BOARD OF PHARMACY |
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28366 | TX | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258848000000",
"number": "1922336494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3403 TEXAS PKWY",
"city": "MISSOURI CITY",
"state": "TX",
"postal_code": "774895202",
"telephone_number": "281-438-3557",
"fax_number": "281-438-7820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3403 TEXAS PKWY",
"city": "MISSOURI CITY",
"state": "TX",
"postal_code": "774895202",
"telephone_number": "281-438-3557",
"fax_number": "281-438-7820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "BIRDIE",
"middle_name": "MAE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-22",
"last_updated": "2009-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "28366",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE BOARD OF PHARMACY",
"identifier": "28366",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Missouri City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.