Jeffrey D Reiser, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

2009020963 Issued in MO

Practice address

9433 Manchester Rd
Saint Louis, MO 63119-1456

Phone

(314) 961-3281

NPI assigned

Sep 2, 2011

Reactivated

May 26, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Missouri CVS Pharmacy LLC

  • Pharmacy
  • Saint Louis, MO
  • NPI 1073361952
  NPD (past)

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1114208121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9433 MANCHESTER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631191456",
            "telephone_number": "314-961-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9433 MANCHESTER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631191456",
            "telephone_number": "314-961-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISER",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-02",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "deactivation_date": "2022-03-25",
        "reactivation_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2009020963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "361924025",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606121804",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Connor Robert Reis, DO
• Martha Jacqueline Reis
• Martin Nicholas Reis, MD
• Megan Jae Reis, OTR
• Emily Suzanne Reisenbichler, M.D.
• Janet Reisert
• Theresa Reisner
• Chris Reiter
• Michael Joseph Reiter, MD
• Shawn Reiter, DC

• All providers in Saint Louis, MO
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.