DR. KELLY KLIEWER (NPI# 1386032506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386032506 |
| Entity Type | Individual |
| Full Name | DR. KELLY KLIEWER |
| Credential | PHARMD |
| Practice Address |
221 3rd St W Jbsa Randolph TX 78150-4800 |
| Practice Telephone | 2106526403 |
| Mailing Telephone | 2106526403 |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2018-04-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
3643 | WY | Pharmacy Service Providers |
| Street Address |
221 3RD ST W |
| City | JBSA RANDOLPH |
| State | TX |
| Zip Code | 78150-4800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881104875 | Virginia L Frazier | Nurse Practitioner | 221 3rd St W, Jbsa Randolph, TX 78150-4800 | 2017-10-04 |
| 1750831152 | Lauren Kester | Dietitian, Registered | 221 3rd St W, Jbsa Randolph, TX 78150-4800 | 2016-10-10 |
| 1346671765 | Kevin Graham | Physician Assistant | 221 3rd St W, Jbsa Randolph, TX 78150-4800 | 2013-12-11 |
| 1891033601 | Anh Phoa Anh Nguyen | Physician Assistant | 221 3rd St W, Jbsa Randolph, TX 78150-4800 | 2013-01-29 |
| 1780920819 | Rachael L Parrish | Dentist | 221 3rd St W, Jbsa Randolph, TX 78150 | 2012-12-18 |
| 1649527508 | Megan Jenifer Graff | Dentist | 221 3rd St W, Jbsa Randolph, TX 78150-4800 | 2012-08-10 |
| 1518221233 | Rebecca Lorraine Englebretson | Family Medicine | 221 3rd St W, Jbsa Randolph, TX 78150-4800 | 2012-06-27 |
| 1093005472 | William Chad Roasa | Physician Assistant | 221 3rd St W, Jbsa Randolph, TX 78150-4800 | 2011-04-19 |
| 1174821771 | Jonathan Paul Kruze | Dentist | 221 3rd St W, Jbsa Randolph, TX 78150-4800 | 2011-03-05 |
| 1609178995 | Kathy Presper | Nurse Practitioner | 221 3rd St W, Jbsa Randolph, TX 78150-4800 | 2010-11-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770045833 | Erica Renae Guevara | Physician Assistant | 559 Medial Sq, 221 Third Street West Bldg. 1040, Jbsa-randolph Afb, TX 78150 | 2019-04-05 |
| 1457803868 | Emily Newman | Dietitian, Registered | 221 Third Street West, Bldg. 999 Ste 2, Joint Base San Antonio -randolph, TX 78150 | 2016-11-02 |
| 1922411677 | Amber Drewer | Military Health Care Provider | 3rd Street West Building 1040, Randolph Afb, TX 78150 | 2014-06-10 |
| 1144652975 | Josephine Kimberly Olsen | Family Medicine | 359 Mdos/mdg, Randolph Afb, TX 78150 | 2013-08-02 |
| 1609149681 | Lucky Lusterio | Preventive Medicine | 221 3rd St. W, Randolph Afb, TX 78150 | 2012-02-21 |
| 1417120569 | Joni Hodgson | General Practice | 221 3rd Street West, Jbsa Randolph, TX 78150 | 2008-04-09 |
| 1710095724 | Katherine Justen Adamson | Physician Assistant | 12th Medical Group, 221 3rd Street West, Randolph Air Force Base, TX 78150 | 2006-08-29 |
| 1811950090 | Lidia Stana Ilcus | Internal Medicine | 359 Mdg, 221 Third Street West, Randolph Afb, TX 78150 | 2006-04-10 |
| 1013970672 | David Hamilton | Social Worker | 12mdos/sgohf, Randolph Afb, TX 78150 | 2006-04-06 |
| 1962465526 | Robert Allan Briggs | Physical Therapist | Randolph Afb Clinic, 221 3rd St W, Randolph Afb, TX 78150 | 2006-04-06 |
| Find all providers in zip 78150 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275151193 | Lori Jean Krustchinsky | Pharmacist | 1220 Hobbs Reach Ln, Houston, TX 77008-6464 | 2020-07-07 |
| 1699390609 | Vincent Wong | Pharmacist | 13501 Hymeadow Cir, Austin, TX 78729-1763 | 2020-06-15 |
| 1750917282 | Ayeshia Duru | Pharmacist | 1321 Canterbury Dr, Allen, TX 75013-7067 | 2020-03-16 |
| 1639703416 | Uchenna Comfort Orji | Pharmacist | 8803 Noah Lndg, Houston, TX 77064-4392 | 2020-03-02 |
| 1316577695 | Osita Stephen Okafor Jr. | Pharmacist | 8440 N Sam Houston Pkwy E Apt 832, Humble, TX 77396-2971 | 2020-01-25 |
| 1023658093 | Islam Abdelhamid | Pharmacist | 1911 Holcombe Blvd Apt 1728, Houston, TX 77030-4192 | 2020-01-08 |
| 1851934640 | Karen Ugwu | Pharmacist | 1212 Corporate Dr, Irving, TX 75038-2502 | 2019-10-24 |
| 1588136675 | Jose Martin Penaloza | Pharmacist | 12002 Barrycliff Ct, Houston, TX 77070-5447 | 2018-12-30 |
| 1790252054 | Jenna Lynne Snoga | Pharmacist | 7400 Merton Minter San Antonio, San Antonio, TX 78229 | 2018-10-25 |
| 1679048151 | Richard William Molinaro Jr. | Pharmacist | 708 Tall Pines Dr, Friendswood, TX 77546-4456 | 2018-10-10 |
| Find all providers with the same taxonomy | ||||
| City | JBSA RANDOLPH |
| Zip Code | 78150 |
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| 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.