Active NPI
Justin David Greenhagen
- Pharmacist
- Liberty, MO
National Provider Identifier
1023493525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2015025598
- Practice address
- 1191 W Kansas St
Liberty, MO 64068-2281 - Phone
- (816) 781-9347
- NPI assigned
- Jul 25, 2015
- 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 | 2015025598 | MO | Primary |
Addresses
Primary practice location
1191 W Kansas St
Liberty, MO 64068-2281
Mailing address
1191 W Kansas St
Liberty, MO 64068-2281
Phone (816) 781-9347
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015025598 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437782400000",
"number": "1023493525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1191 W KANSAS ST",
"city": "LIBERTY",
"state": "MO",
"postal_code": "640682281",
"telephone_number": "816-781-9347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1191 W KANSAS ST",
"city": "LIBERTY",
"state": "MO",
"postal_code": "640682281",
"telephone_number": "816-781-9347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENHAGEN",
"first_name": "JUSTIN",
"middle_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-25",
"last_updated": "2015-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2015025598",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liberty, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.