Individual provider Active NPI

Julie Deibel, PHARMD

  • Pharmacist
  • Bridgeton, MO
National Provider Identifier
1225708472
Registry record updated Sep 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2021038162 Issued in MO
Practice address
3550 McKelvey Rd Ste 100B
Bridgeton, MO 63044-2527
Phone
(314) 218-9660
NPI assigned
Sep 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2021038162 MO Primary

Addresses

Primary practice location

3550 McKelvey Rd Ste 100B
Bridgeton, MO 63044-2527

Mailing address

20 Riverwood Estates Blvd
Florissant, MO 63031-6528
Phone (314) 591-8639

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
2021038162MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1632009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632009600000",
    "number": "1225708472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 RIVERWOOD ESTATES BLVD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630316528",
            "telephone_number": "314-591-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 MCKELVEY RD STE 100B",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442527",
            "telephone_number": "314-218-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEIBEL",
        "first_name": "JULIE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-19",
        "last_updated": "2021-09-19",
        "certification_date": "2021-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2021038162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2021; 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.