Individual provider Active NPI

Roger Dale St.Clair Jr., PHARM.D.

  • Pharmacist
  • Richmond, VA
National Provider Identifier
1104062132
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202208333 Issued in VA
Practice address
2015 Staples Mill Rd
Richmond, VA 23230-3108
Phone
(804) 354-7000
NPI assigned
Dec 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0000034094 TN
Pharmacist 183500000X 025333 GA
Pharmacist 183500000X 0202208333 VA Primary

Addresses

Primary practice location

2015 Staples Mill Rd
Richmond, VA 23230-3108

Mailing address

10448 Lakeridge Pkwy
Ashland, VA 23005-8124
Phone (804) 550-4859

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

LicenseStateTypeSpecialty
025333GAMDPharmacist
0000034094TNMDPharmacist
0202208333VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1104062132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10448 LAKERIDGE PKWY",
            "city": "ASHLAND",
            "state": "VA",
            "postal_code": "230058124",
            "telephone_number": "804-550-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 STAPLES MILL RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303108",
            "telephone_number": "804-354-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST.CLAIR",
        "first_name": "ROGER",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-22",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "0000034094",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "025333",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202208333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.