Active NPI
Michael Heeter
- Pharmacist
- Maryland Heights, MO
National Provider Identifier
1205312220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2013027420
- Practice address
- 2030 Dorsett VLG
Maryland Heights, MO 63043-2208 - Phone
- (314) 434-5496
- NPI assigned
- Jul 12, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 | 2013027420 | MO | Primary |
Addresses
Primary practice location
2030 Dorsett VLG
Maryland Heights, MO 63043-2208
Mailing address
5026 Potomac St
Saint Louis, MO 63139-1317
Phone (314) 406-2524
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 |
|---|---|---|---|
| 2013027420 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531353600000",
"number": "1205312220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5026 POTOMAC ST",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631391317",
"telephone_number": "314-406-2524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2030 DORSETT VLG",
"city": "MARYLAND HEIGHTS",
"state": "MO",
"postal_code": "630432208",
"telephone_number": "314-434-5496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEETER",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-12",
"last_updated": "2018-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2013027420",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maryland Heights, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.