Active NPI
Kevin Joseph Noonan, PHARMD
- Pharmacist
- Wentzville, MO
National Provider Identifier
1316549165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2020033523
- Practice address
- 1053 Meyer Rd
Wentzville, MO 63385-3457 - Phone
- (636) 332-2443
- NPI assigned
- Nov 16, 2020
- Last updated
- Nov 16, 2020
- Sex
- Male
- 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 | 2020033523 | MO | Primary |
Addresses
Primary practice location
1053 Meyer Rd
Wentzville, MO 63385-3457
Mailing address
1053 Meyer Rd
Wentzville, MO 63385-3457
Phone (636) 332-2443
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 |
|---|---|---|---|
| 2020033523 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1053 Meyer Rd
Wentzville, MO 63385
Phone (636) 332-2443
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": "1605484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1316549165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1053 MEYER RD",
"city": "WENTZVILLE",
"state": "MO",
"postal_code": "633853457",
"telephone_number": "636-332-2443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1053 MEYER RD",
"city": "WENTZVILLE",
"state": "MO",
"postal_code": "633853457",
"telephone_number": "636-332-2443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOONAN",
"first_name": "KEVIN",
"middle_name": "JOSEPH",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-16",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2020033523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wentzville, MO
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- Next Step Foot and Ankle Centers, Inc. (More Than Just Podiatry)
- Jennifer Lan-CHI Nguyen, M.D.
- Casey N Niekamp
- Nancy E Noel, MD
- Northland Hearing Center, Inc. (Southwestern Hearing Center)
- Jillian Norton, LP
- Leah Norvell, DMD
- Sarah Nowak, LPC
- Renee Marie Nowakowski, LPC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.