Active NPI
Konnor Mariah Jenkins, PHARM.D.
- Pharmacist
- Fredericktown, MO
National Provider Identifier
1306634969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2024035075
- Practice address
- 1025 Highway 72 Byp
Fredericktown, MO 63645-7326 - Phone
- (573) 783-6000
- NPI assigned
- Apr 25, 2025
- Last updated
- Apr 25, 2025
- Sex
- Female
- Sole proprietor
- No
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 | 2024035075 | MO | Primary |
Addresses
Primary practice location
1025 Highway 72 Byp
Fredericktown, MO 63645-7326
Mailing address
330 Wayne 404
Greenville, MO 63944-8799
Phone (573) 944-3318
Other practice location 1
137 Front St
Greenville, MO 63944-8111
Phone (573) 223-8062
Other practice location 2
420 Piedmont Ave
Piedmont, MO 63957-1024
Phone (573) 223-4235
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2024035075 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parkland Pharmacy Development LLC | 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 Parkland Pharmacy
- Community/Retail Pharmacy
- Greenville, MO
- NPI 1972109619
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745539200000",
"number": "1306634969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 WAYNE 404",
"city": "GREENVILLE",
"state": "MO",
"postal_code": "639448799",
"telephone_number": "573-944-3318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 HIGHWAY 72 BYP",
"city": "FREDERICKTOWN",
"state": "MO",
"postal_code": "636457326",
"telephone_number": "573-783-6000"
}
],
"practiceLocations": [
{
"address_1": "137 Front St",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "MO",
"postal_code": "639448111",
"country_code": "US",
"telephone_number": "573-223-8062",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "420 Piedmont Ave",
"address_purpose": "LOCATION",
"city": "Piedmont",
"state": "MO",
"postal_code": "639571024",
"country_code": "US",
"telephone_number": "573-223-4235",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JENKINS",
"first_name": "KONNOR",
"middle_name": "MARIAH",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-25",
"last_updated": "2025-04-25",
"certification_date": "2025-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2024035075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fredericktown, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.