Active NPI
Robert William Martin
- Pharmacist
- Bowling Green, MO
National Provider Identifier
1285923508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 041749
- Practice address
- 1106 S Business Highway 61
Bowling Green, MO 63334-5233 - Phone
- (573) 324-3383
- Fax
- (573) 324-6388
- NPI assigned
- Apr 7, 2011
- Last updated
- Apr 7, 2011
- 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 | 041749 | MO | Primary |
Addresses
Primary practice location
1106 S Business Highway 61
Bowling Green, MO 63334-5233
Mailing address
1106 S Business Highway 61
Bowling Green, MO 63334-5233
Phone (573) 324-3383
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 600121420 | Medicaid | MO |
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 |
|---|---|---|---|
| 041749 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Niemann Foods Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba County Market Pharmacy 397
- Community/Retail Pharmacy
- Bowling Green, MO
- NPI 1366424491
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302134400000",
"number": "1285923508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1106 S BUSINESS HIGHWAY 61",
"city": "BOWLING GREEN",
"state": "MO",
"postal_code": "633345233",
"telephone_number": "573-324-3383",
"fax_number": "573-324-6388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1106 S BUSINESS HIGHWAY 61",
"city": "BOWLING GREEN",
"state": "MO",
"postal_code": "633345233",
"telephone_number": "573-324-3383",
"fax_number": "573-324-6388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ROBERT",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-07",
"last_updated": "2011-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "041749",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "600121420",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bowling Green, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.