Khadijah Akilah Roberts

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

2022033660 Issued in MO

Practice address

12098 Lusher Rd
Saint Louis, MO 63138-1302

Phone

(314) 355-0500

NPI assigned

Sep 30, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: rxm.04824@store.walgreens.com

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1225752595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12098 LUSHER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631381302",
            "telephone_number": "314-355-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12098 LUSHER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631381302",
            "telephone_number": "314-355-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KHADIJAH",
        "middle_name": "AKILAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-30",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "MO",
            "license": "2022033660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Rxm.04824@store.walgreens.com",
            "affiliation": "Y",
            "endpointDescription": "Job email",
            "affiliationName": "WALGREEN CO",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Job",
            "address_1": "12098 Lusher Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631381302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joy Roberts, MSW
• Kaleigh Filisa Roberts, MD, PHD
• Kandice Roberts, MD
• Kelly M Roberts, FNP-C
• Kelsey Roberts, MD
• Lisa Jane Marie Lukies Roberts, LMSW
• Matthew C Roberts, NP-C
• Maxine Roberts
• Meredith D. Roberts, M.S.
• Michelle Dawn Roberts, LPC, NCC

• Pharmacy Technician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pharmacy Technician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.