Active NPI
Lisa Marie Presley
- Pharmacist
- Kirkwood, MO
National Provider Identifier
1053897702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2001030602
- Practice address
- 10233 Manchester Rd
Kirkwood, MO 63122-1532 - Phone
- (314) 965-4533
- Fax
- (314) 965-3516
- NPI assigned
- Jul 16, 2018
- Sex
- Female
- 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 | 2001030602 | MO | Primary |
Addresses
Primary practice location
10233 Manchester Rd
Kirkwood, MO 63122-1532
Mailing address
10233 Manchester Rd
Kirkwood, MO 63122-1532
Phone (314) 965-4533
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 |
|---|---|---|---|
| 2001030602 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531699200000",
"number": "1053897702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10233 MANCHESTER RD",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "631221532",
"telephone_number": "314-965-4533",
"fax_number": "314-965-3516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10233 MANCHESTER RD",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "631221532",
"telephone_number": "314-965-4533",
"fax_number": "314-965-3516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRESLEY",
"first_name": "LISA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-16",
"last_updated": "2018-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2001030602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirkwood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.