Active NPI
Chad Rollins
- Pharmacist
- Nixa, MO
National Provider Identifier
1053589952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2004035744
- Practice address
- 105 S Ridgecrest Ave
Nixa, MO 65714-7807 - Phone
- (417) 724-2601
- NPI assigned
- Feb 13, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | 2004035744 | MO | Primary |
Addresses
Primary practice location
105 S Ridgecrest Ave
Nixa, MO 65714-7807
Mailing address
PO Box 1440
Nixa, MO 65714-1440
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 |
|---|---|---|---|
| 2004035744 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Pharmacy of Missouri LLC | Past | Accepting new patients | |
| Family Pharmacy of Missouri LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202860800000",
"number": "1053589952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1440",
"city": "NIXA",
"state": "MO",
"postal_code": "657141440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 S RIDGECREST AVE",
"city": "NIXA",
"state": "MO",
"postal_code": "657147807",
"telephone_number": "417-724-2601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROLLINS",
"first_name": "CHAD",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-13",
"last_updated": "2008-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2004035744",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nixa, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.