Active NPI
Brad Collins
- Pharmacist
- Saint Louis, MO
National Provider Identifier
1063039360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2020018322
- Practice address
- 4240 Duncan Ave Ste 200
Saint Louis, MO 63110-1123 - Phone
- (314) 518-4161
- NPI assigned
- Jul 2, 2020
- 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 | 2020018322 | MO | Primary |
Addresses
Primary practice location
4240 Duncan Ave Ste 200
Saint Louis, MO 63110-1123
Mailing address
8650 Big Bend Blvd
Webster Groves, MO 63119-3839
Phone (314) 961-5222
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 |
|---|---|---|---|
| 2020018322 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virole LLC | Current | Accepting new patients |
Locations
4240 Duncan Ave
Ste 200
Saint Louis, MO 63110
Phone (314) 409-6968
Organizations & group practices 1
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": "1593648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1063039360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8650 BIG BEND BLVD",
"city": "WEBSTER GROVES",
"state": "MO",
"postal_code": "631193839",
"telephone_number": "314-961-5222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4240 DUNCAN AVE STE 200",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101123",
"telephone_number": "314-518-4161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "BRAD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-02",
"last_updated": "2020-12-02",
"certification_date": "2020-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2020018322",
"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 Dec 2, 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.