Individual provider Active NPI

Obe Omoike, PHARMD

  • Pharmacist
  • Saint Joseph, MO
National Provider Identifier
1104429406
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2005000320 Issued in MO
Practice address
930 N Belt Hwy
Saint Joseph, MO 64506-3013
Phone
(816) 233-1353
Fax
(816) 233-7635
NPI assigned
Nov 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2005000320 MO Primary

Addresses

Primary practice location

930 N Belt Hwy
Saint Joseph, MO 64506-3013

Mailing address

10308 N Lucerne Ave
Kansas City, MO 64154-1868
Phone (816) 326-8813

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
2005000320MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri CVS Pharmacy LLC PastSince Nov 22, 2020 Accepting new patients
Missouri CVS Pharmacy, L.L.C. PastSince Nov 22, 2020 Accepting new patients

Organizations & group practices 2

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": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1104429406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10308 N LUCERNE AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641541868",
            "telephone_number": "816-326-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 N BELT HWY",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063013",
            "telephone_number": "816-233-1353",
            "fax_number": "816-233-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMOIKE",
        "first_name": "OBE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2005000320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.

Verify at the official NPI Registry.