Individual provider Active NPI

Jiajing Wang

  • Pharmacist
  • Lake St Louis, MO
National Provider Identifier
1104739341
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2026043760 Issued in MO
Practice address
100 Medical PLZ
Lake St Louis, MO 63367-1366
Phone
(636) 625-5200
NPI assigned
Sep 28, 2026
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2026043760 MO Primary

Addresses

Primary practice location

100 Medical PLZ
Lake St Louis, MO 63367-1366

Mailing address

31202 Pomme de Terre Dr
Lake St Louis, MO 63367-2170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1104739341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31202 POMME DE TERRE DR",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633672170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PLZ",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671366",
            "telephone_number": "636-625-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "JIAJING",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-09-28",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2026043760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.