Active NPI
Kelly Ray Earhart, PHARM. D.
- Pharmacist
- Enid, OK
National Provider Identifier
1942814033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13003
- Practice address
- 305 S 5TH St
Enid, OK 73701-5832 - Phone
- (580) 249-3062
- Fax
- (580) 249-3736
- NPI assigned
- Sep 4, 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 | 13003 | OK | Primary |
Addresses
Primary practice location
305 S 5TH St
Enid, OK 73701-5832
Mailing address
4529 S Covered Wagon TRL
Enid, OK 73701-8546
Phone (580) 977-7153
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13003 | Other | OK | PHARMACIST |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13003 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599177600000",
"number": "1942814033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4529 S COVERED WAGON TRL",
"city": "ENID",
"state": "OK",
"postal_code": "737018546",
"telephone_number": "580-977-7153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 S 5TH ST",
"city": "ENID",
"state": "OK",
"postal_code": "737015832",
"telephone_number": "580-249-3062",
"fax_number": "580-249-3736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EARHART",
"first_name": "KELLY",
"middle_name": "RAY",
"credential": "PHARM. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-04",
"last_updated": "2020-09-04",
"certification_date": "2020-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "13003",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST",
"identifier": "13003",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Enid, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.