Individual provider Active NPI

Christine Michelle Coffman, RPH

  • Pharmacist
  • Mountain Grove, MO
National Provider Identifier
1124777362
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
043499 Issued in MO
Practice address
1600 N Main St
Mountain Grove, MO 65711-1010
Phone
(417) 926-9655
Fax
(417) 926-0045
NPI assigned
Mar 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 043499 MO Primary

Addresses

Primary practice location

1600 N Main St
Mountain Grove, MO 65711-1010

Mailing address

1600 N Main St
Mountain Grove, MO 65711-1010
Phone (417) 926-9655

Other practice location 1

106 N Union St
Mountain Grove, MO 65711-1724
Phone (417) 926-4156

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
043499MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Pharmacy of Mountain Grove LLC CurrentSince Mar 27, 2022 Accepting new patients
Hometown Pharmacy Management LLC Current Accepting new patients
Mountain Grove Pharmacy Inc Current Accepting new patients

Locations

1600 N Main St
Mountain Grove, MO 65711
Phone (417) 217-1012

106 N Union St
Mountain Grv, MO 65711
Phone (417) 217-1012

Organizations & group practices 3

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": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1124777362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 N MAIN ST",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111010",
            "telephone_number": "417-926-9655",
            "fax_number": "417-926-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N MAIN ST",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111010",
            "telephone_number": "417-926-9655",
            "fax_number": "417-926-0045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 N Union St",
            "address_purpose": "LOCATION",
            "city": "Mountain Grove",
            "state": "MO",
            "postal_code": "657111724",
            "country_code": "US",
            "telephone_number": "417-926-4156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "CHRISTINE",
        "middle_name": "MICHELLE",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "043499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Grove, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.