Individual provider Active NPI

John Paul Mullane, RPH

  • Pharmacist
  • Florissant, MO
National Provider Identifier
1093009227
Registry record updated Jul 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
042071 Issued in MO
Practice address
13987 New Halls Ferry Rd
Florissant, MO 63033-2943
Phone
(314) 831-1515
Fax
(314) 831-1538
NPI assigned
Jun 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 042071 MO Primary
Pharmacist 183500000X 051036945 IL

Addresses

Primary practice location

13987 New Halls Ferry Rd
Florissant, MO 63033-2943

Mailing address

13987 New Halls Ferry Rd
Florissant, MO 63033-2943
Phone (314) 831-1515

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
051036945ILMDPharmacist
042071MOMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436054400000",
    "number": "1093009227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13987 NEW HALLS FERRY RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630332943",
            "telephone_number": "314-831-1515",
            "fax_number": "314-831-1538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13987 NEW HALLS FERRY RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630332943",
            "telephone_number": "314-831-1515",
            "fax_number": "314-831-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLANE",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-06",
        "last_updated": "2015-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "042071",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051036945",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.

Verify at the official NPI Registry.