Individual provider Active NPI

Steven Paul Pinneke, PHARM D

  • Pharmacist
  • Normal, IL
National Provider Identifier
1104059377
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051.032188 Issued in IL
Practice address
1304 Franklin Ave.
Normal, IL 61761-3558
Phone
(309) 268-5199
Fax
(309) 888-0902
NPI assigned
Sep 3, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.032188 IL Primary

Addresses

Primary practice location

1304 Franklin Ave.
Normal, IL 61761-3558

Mailing address

1304 Franklin Ave.
Normal, IL 61761-3558
Phone (309) 268-5199

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

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251936000000",
    "number": "1104059377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 FRANKLIN AVE.",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613558",
            "telephone_number": "309-268-5199",
            "fax_number": "309-888-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 FRANKLIN AVE.",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613558",
            "telephone_number": "309-268-5199",
            "fax_number": "309-888-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINNEKE",
        "first_name": "STEVEN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-03",
        "last_updated": "2009-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.032188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; 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.