Individual provider Active NPI

Jeremy Davis, PHARM D.

  • Pharmacist
  • Saint Louis, MO
National Provider Identifier
1013291210
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2009021428 Issued in MO
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

Updated by the provider on Nov 24, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
2009021428MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri CVS Pharmacy, L.L.C. PastSince Nov 29, 2020 Accepting new patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients
Missouri CVS Pharmacy LLC PastSince Nov 29, 2020 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.

Verify at the official NPI Registry.