Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1134731235 Deactivated / Inactive NPI Female Practitioner

Dr. Kelly Dietzel , PharmD

Pharmacist • Payson, AZ

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Kelly Dietzel has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 19, 2020
NPI Deactivation Date August 28, 2025
Total Practice Duration ~5 Years of Practice (2020 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Kelly Dietzel, PharmD was a registered Pharmacist practicing in Payson, AZ. Throughout an active medical career spanning 5 years, Dr. Dietzel provided care at the practice location at 100 S BEELINE HWY until profile deactivation on 2025-08-28.

Practice Location & Contact Primary Location

Practice Address

100 S Beeline Hwy

Payson, AZ 855414809

Telephone 9284741599
Associated Practice Facility / Clinic
🏢 Walgreen Co Facility NPI 1033124375

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Payson, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 5.0 Yrs
Regional Practice Density
23 Specialists

Practicing in Payson, AZ (6928 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License AZ S024574

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1174803084

Registered Pharmacist

NPI 1194055285
NPI 1649557810

Registered Pharmacist

NPI 1699075234

Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
⚠️
NPI Profile Deactivated August 28, 2025

Record deactivated on August 28, 2025

NPI Profile Active August 19, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location August 19, 2020

Registered at 100 S BEELINE HWY, PAYSON, AZ 855414809 (Tel: 9284741599)

📍
Updated Business Mailing Address August 19, 2020

Registered at 903 S SUTTON RD, PAYSON, AZ 855415842

👤
Provider Name / Credentials Updated August 19, 2020

Recorded as KELLY DIETZEL, PHARMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 19, 2020

Pharmacist (License #S024574 in AZ)

🟢
Initial NPI Registration & Enumeration August 19, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Kelly Dietzel. Be the first to share your experience!

Sign in to leave a review for Dr. Kelly Dietzel

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1134731235
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 19, 2020
Last Update: August 19, 2020
Deactivation Date: August 28, 2025

Mailing Address

903 S Sutton Rd

Payson, AZ 855415842

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.