Individual provider Active NPI

Julie Ann Schrock, PHARMD

  • Pharmacist
  • High Ridge, MO
National Provider Identifier
1154688679
Registry record updated Apr 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2008027487 Issued in MO
Practice address
4560 Gravois Village Ctr
High Ridge, MO 63049-1838
Phone
(636) 376-5000
Fax
(636) 376-1870
NPI assigned
Apr 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2008027487 MO Primary
Pharmacist 183500000X S015143 AZ

Addresses

Primary practice location

4560 Gravois Village Ctr
High Ridge, MO 63049-1838

Mailing address

4560 Gravois Village Ctr
High Ridge, MO 63049-1838
Phone (636) 376-5000

Other identifiers 1

IdentifierTypeStateIssuer
2008027487OtherMOSTATE LICENSE

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
S015143AZMDPharmacist
2008027487MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334880000000",
    "number": "1154688679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 GRAVOIS VILLAGE CTR",
            "city": "HIGH RIDGE",
            "state": "MO",
            "postal_code": "630491838",
            "telephone_number": "636-376-5000",
            "fax_number": "636-376-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 GRAVOIS VILLAGE CTR",
            "city": "HIGH RIDGE",
            "state": "MO",
            "postal_code": "630491838",
            "telephone_number": "636-376-5000",
            "fax_number": "636-376-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROCK",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-20",
        "last_updated": "2012-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2008027487",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S015143",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2008027487",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Ridge, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; 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.