Active NPI
Cleora Katherine Jennings, PHARMD
- Pharmacist
- Osage Beach, MO
National Provider Identifier
1063794907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2011027373
- Practice address
- 54 Hospital Dr
Osage Beach, MO 65065-3050 - Phone
- (417) 532-4431
- Fax
- (417) 532-4431
- NPI assigned
- Sep 16, 2011
- 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 | 2011027373 | MO | Primary |
Addresses
Primary practice location
54 Hospital Dr
Osage Beach, MO 65065-3050
Mailing address
1057 Medical Park Dr
Osage Beach, MO 65065-3000
Phone (573) 302-2700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2011027373 | Other | MO | PHARMACIST LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2011027373 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687132800000",
"number": "1063794907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1057 MEDICAL PARK DR",
"city": "OSAGE BEACH",
"state": "MO",
"postal_code": "650653000",
"telephone_number": "573-302-2700",
"fax_number": "573-302-2701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 HOSPITAL DR",
"city": "OSAGE BEACH",
"state": "MO",
"postal_code": "650653050",
"telephone_number": "417-532-4431",
"fax_number": "417-532-4431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENNINGS",
"first_name": "CLEORA",
"middle_name": "KATHERINE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-16",
"last_updated": "2023-06-19",
"certification_date": "2023-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2011027373",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "2011027373",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Osage Beach, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.