Individual provider Active NPI

Randy Kyle Meents, PHARM.D.

  • Geriatric Pharmacist
  • Greenfield, MO
National Provider Identifier
1164407557
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric PharmacistTaxonomy code 1835G0303X
License
040294 Issued in MO
Practice address
105 N. Grand St., Suite 1
Greenfield, MO 65661-0158
Phone
(417) 637-2909
Fax
(417) 637-5621
NPI assigned
Dec 8, 2005
Last updated
Dec 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 040294 MO
Pharmacotherapy Pharmacist 1835P1200X 040294 MO
Geriatric Pharmacist 1835G0303X 040294 MO Primary

Addresses

Primary practice location

105 N. Grand St., Suite 1
Greenfield, MO 65661-0158

Mailing address

105 N. Grand St., Suite 1
P.O. Box 158
Greenfield, MO 65661-0158
Phone (417) 637-2909

Other identifiers 1

IdentifierTypeStateIssuer
358397800MedicaidMO

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
040294MOMDPharmacist

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1164407557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N. GRAND ST., SUITE 1",
            "address_2": "P.O. BOX 158",
            "city": "GREENFIELD",
            "state": "MO",
            "postal_code": "656610158",
            "telephone_number": "417-637-2909",
            "fax_number": "417-637-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N. GRAND ST., SUITE 1",
            "city": "GREENFIELD",
            "state": "MO",
            "postal_code": "656610158",
            "telephone_number": "417-637-2909",
            "fax_number": "417-637-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEENTS",
        "first_name": "RANDY",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "040294",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MO",
            "license": "040294",
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "MO",
            "license": "040294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "358397800",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; 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.