Active NPI
Victoria Krysten Smith
- Pharmacist
- Ozark, MO
National Provider Identifier
1174136378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2018027959
- Practice address
- 1675 W South St
Ozark, MO 65721-5152 - Phone
- (417) 485-0762
- NPI assigned
- Aug 26, 2020
- Last updated
- Jan 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2018027959 | MO | Primary |
Addresses
Primary practice location
1675 W South St
Ozark, MO 65721-5152
Mailing address
1675 W South St
Ozark, MO 65721-5152
Phone (417) 485-0762
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2018027959 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1675 W South St
Ozark, MO 65721
Phone (417) 485-0762
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": "1598400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705536000000",
"number": "1174136378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1675 W SOUTH ST",
"city": "OZARK",
"state": "MO",
"postal_code": "657215152",
"telephone_number": "417-485-0762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1675 W SOUTH ST",
"city": "OZARK",
"state": "MO",
"postal_code": "657215152",
"telephone_number": "417-485-0762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "VICTORIA",
"middle_name": "KRYSTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-26",
"last_updated": "2024-01-18",
"certification_date": "2024-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2018027959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ozark, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.