Individual provider Active NPI

Lindsey Ballard Corlew, PHARM D

  • Pharmacist
  • Sikeston, MO
National Provider Identifier
1285040204
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2007023337 Issued in MO
Practice address
808 Hunter Ave
Suite 1
Sikeston, MO 63801-2248
Phone
(573) 472-0608
Fax
(573) 472-1814
NPI assigned
Jul 10, 2014
Last updated
Jul 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2007023337 MO Primary
Pharmacotherapy Pharmacist 1835P1200X 2007023337 MO

Addresses

Primary practice location

808 Hunter Ave
Suite 1
Sikeston, MO 63801-2248

Mailing address

808 Hunter Ave
Suite 1
Sikeston, MO 63801-2248
Phone (573) 472-0608

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
2007023337MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
B Y Enterprises Inc Past Accepting new patients
B Y Enterprises Inc Past Accepting new patients

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": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1285040204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 HUNTER AVE",
            "address_2": "SUITE 1",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638012248",
            "telephone_number": "573-472-0608",
            "fax_number": "573-472-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 HUNTER AVE",
            "address_2": "SUITE 1",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638012248",
            "telephone_number": "573-472-0608",
            "fax_number": "573-472-1814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLEW",
        "first_name": "LINDSEY",
        "middle_name": "BALLARD",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2007023337",
            "primary": true
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MO",
            "license": "2007023337",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sikeston, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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.