Active NPI
Jeremy Davis, PHARM D.
- Pharmacist
- Saint Louis, MO
National Provider Identifier
1013291210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2009021428
- Practice address
- 7320 Gravois Ave
Saint Louis, MO 63116-1021 - Phone
- (314) 351-6728
- NPI assigned
- Oct 6, 2011
- 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 | 2009021428 | MO | Primary |
Addresses
Primary practice location
7320 Gravois Ave
Saint Louis, MO 63116-1021
Mailing address
6029 Devonshire Ave.
St. Louis, MO 63109
Phone (636) 232-6037
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 |
|---|---|---|---|
| 2009021428 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Missouri CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Missouri CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 4
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": "1317859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606176000000",
"number": "1013291210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6029 DEVONSHIRE AVE.",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "63109",
"telephone_number": "636-232-6037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7320 GRAVOIS AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631161021",
"telephone_number": "314-351-6728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JEREMY",
"credential": "PHARM D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-06",
"last_updated": "2020-11-24",
"certification_date": "2020-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2009021428",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.