Individual provider Active NPI

Stefan Santiago Menchaca

  • Pharmacist
  • Saint Louis, MO
National Provider Identifier
1154934073
Registry record updated Aug 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2018036335 Issued in MO
Practice address
7199 Natural Bridge Rd
Saint Louis, MO 63121-5143
Phone
(314) 382-9926
NPI assigned
Aug 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2018036335 MO Primary

Addresses

Primary practice location

7199 Natural Bridge Rd
Saint Louis, MO 63121-5143

Mailing address

7199 Natural Bridge Rd
Saint Louis, MO 63121-5143

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

LicenseStateTypeSpecialty
2018036335MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1598659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598659200000",
    "number": "1154934073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7199 NATURAL BRIDGE RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631215143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7199 NATURAL BRIDGE RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631215143",
            "telephone_number": "314-382-9926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENCHACA",
        "first_name": "STEFAN",
        "middle_name": "SANTIAGO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-29",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2018036335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2020; 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.