MR. WILLIAM KELLY BOUTWELL (NPI# 1336703362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336703362 |
| Entity Type | Individual |
| Full Name | MR. WILLIAM KELLY BOUTWELL |
| Credential | RPH |
| Practice Address |
428 Highway 51 N Brookhaven MS 39601-2351 |
| Practice Telephone | 6018337455 |
| Practice Fax Number | 6018333987 |
| Mailing Telephone | 6018337455 |
| Mailing Fax Number | 6018333987 |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2019-04-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | E08687 | MS | Pharmacy Service Providers |
| Street Address |
428 HIGHWAY 51 N |
| City | BROOKHAVEN |
| State | MS |
| Zip Code | 39601-2351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346251857 | Brandt L Baker Jr | Pharmacy | 428 Highway 51 N, Brookhaven, MS 39601-2351 | 2006-08-10 |
| 1083278089 | Brandon Baker | Pharmacist | 428 Highway 51 N, Brookhaven, MS 39601-2351 | 2019-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093329633 | Mary Lindsey Lumley | Nurse Practitioner | 620 Hwy 51, Brookhaven, MS 39601 | 2020-09-01 |
| 1306371687 | Rocky Mountain Holdings, LLC | Ambulance | 411 Highway 51 N, Brookhaven, MS 39601 | 2017-04-25 |
| 1043759269 | Candace C Turner | Counselor | 860 E River Pl Suite 100, Jackson, MS 39601 | 2017-02-21 |
| 1619419694 | Therapy Nook PC | Speech-Language Pathologist | 520 Schwem Avenue, Brookhaven, MS 39601 | 2016-11-08 |
| 1851742639 | Melanie Smith | Specialist/Technologist | 325 Low Water Lane, Brookhaven, MS 39601 | 2016-06-23 |
| 1134597107 | Passionate Care Home Health,llc | Home Health | 537 St Charles Places, Brookhaven, MS 39601 | 2015-09-09 |
| 1205218690 | Nurse Practitioner Professionals, Pllc | Clinic/Center | 427 Highway 51 Se, Kings Daughters Medical Center-wound Healing Center, Brookhaven, MS 39601 | 2015-06-23 |
| 1043639289 | Joseph S Moak Jr Md Pa | Internal Medicine | 1040 Biglane Drive, Brookhaven, MS 39601 | 2014-04-15 |
| 1902239197 | Melanie Hammill Bishop | Pharmacist | 427 Ms Highway 51 North, Brookhaven, MS 39601 | 2013-08-12 |
| 1386930113 | Hospice Advantage, LLC. | Hospice Care, Community Based | 120 W Cherokee St, Brookhaven, MS 39601 | 2011-06-20 |
| Find all providers in zip 39601 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003416850 | Radina Raytcheva | Pharmacist | 2901 Clairmont Rd Ne, Brookhaven, GA 30329-1639 | 2020-10-30 |
| 1215554787 | Valerie R Tenaglia | Pharmacist | 148 Meadowbrook Ln, Brookhaven, PA 19015-2813 | 2020-07-01 |
| 1548746886 | Jessica Walton | Pharmacist | 3105 Druid Hills Reserve Dr Ne, Brookhaven, GA 30329-2041 | 2018-07-18 |
| 1861900755 | Amy Elizabeth Bixler | Pharmacist | 1200 Lake Hearn Dr Ne Ste 425, Brookhaven, GA 30319-6419 | 2018-01-14 |
| 1215485065 | Joseph Fuselli | Pharmacist | 708 Lincoln Dr, Brookhaven, PA 19015-1019 | 2016-09-21 |
| 1447691696 | James E Crane Jr. | Pharmacist | 839 Boyte Dr Se, Brookhaven, MS 39601-8455 | 2013-07-16 |
| 1508207903 | Kacy Lynn Thomason | Pharmacist | 104 Town Blvd Ne # A100, Brookhaven, GA 30319-3146 | 2013-07-13 |
| 1629345939 | Amanda Dinmore | Pharmacist | 127 Meadowbrook Ln, Brookhaven, PA 19015-2812 | 2011-11-30 |
| 1023393808 | Howard King | Pharmacist | 4930 Edgmont Ave, Brookhaven, PA 19015-1201 | 2011-10-12 |
| 1194034264 | Bill E Blalack | Pharmacist | 218 S Whitworth Ave, Brookhaven, MS 39601-3343 | 2010-10-06 |
| Find all providers in BROOKHAVEN | ||||
| City | BROOKHAVEN |
| Zip Code | 39601 |
Please comment or provide details below to improve the information on MR. WILLIAM KELLY BOUTWELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.