Individual provider Active NPI

Nikhat Banu, DO

  • Mail Order Pharmacy
  • Chesterfield, MO
National Provider Identifier
1174490643
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mail Order PharmacyTaxonomy code 3336M0002X
License
2025040299 Issued in MO
Practice address
400 S Woods Mill Rd Ste 100
Chesterfield, MO 63017-3427
Phone
(844) 963-0320
NPI assigned
Oct 20, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mail Order Pharmacy 3336M0002X 2025040299 MO Primary

Addresses

Primary practice location

400 S Woods Mill Rd Ste 100
Chesterfield, MO 63017-3427

Mailing address

423 Ava Renee Dr
Manchester, MO 63021-5184
Phone (636) 628-5515

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
2025040299MOMDMail Order Pharmacy

NPI Registry JSON

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

{
    "created_epoch": "1760918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1174490643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 AVA RENEE DR",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630215184",
            "telephone_number": "636-628-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S WOODS MILL RD STE 100",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173427",
            "telephone_number": "844-963-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANU",
        "first_name": "NIKHAT",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "MO",
            "license": "2025040299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.