Individual provider Active NPI

Stephen M Calloway, RPH

  • Pharmacist
  • Columbia, MO
National Provider Identifier
1164068912
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
030082 Issued in MO
Practice address
305 N Keene St Ste 107
Columbia, MO 65201-6897
Phone
(573) 256-6272
Fax
(573) 256-6304
NPI assigned
Nov 26, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 030082 MO Primary

Addresses

Primary practice location

305 N Keene St Ste 107
Columbia, MO 65201-6897

Mailing address

3900 Sherman CT
Columbia, MO 65203-5858
Phone (573) 445-8272

Other practice location 1

3900 Sherman Ct
Columbia, MO 65203-5858
Phone (573) 445-8272

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
030082MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1164068912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 SHERMAN CT",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035858",
            "telephone_number": "573-445-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 N KEENE ST STE 107",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016897",
            "telephone_number": "573-256-6272",
            "fax_number": "573-256-6304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 Sherman Ct",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652035858",
            "country_code": "US",
            "telephone_number": "573-445-8272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLOWAY",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-26",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "030082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.