Active NPI
Seth Daniel Alley
- Pharmacist
- Bolivar, MO
National Provider Identifier
1104537588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2015036088
- Practice address
- 1100 S Springfield Ave
Bolivar, MO 65613-2512 - Phone
- (417) 326-2416
- NPI assigned
- Dec 7, 2022
- Sex
- Male
- 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 | 2015036088 | MO | Primary |
Addresses
Primary practice location
1100 S Springfield Ave
Bolivar, MO 65613-2512
Mailing address
1100 S Springfield Ave
Bolivar, MO 65613-2512
Phone (417) 326-2416
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015036088 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670371200000",
"number": "1104537588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 S SPRINGFIELD AVE",
"city": "BOLIVAR",
"state": "MO",
"postal_code": "656132512",
"telephone_number": "417-326-2416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 S SPRINGFIELD AVE",
"city": "BOLIVAR",
"state": "MO",
"postal_code": "656132512",
"telephone_number": "417-326-2416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEY",
"first_name": "SETH",
"middle_name": "DANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-07",
"last_updated": "2022-12-07",
"certification_date": "2022-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2015036088",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bolivar, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.