Individual provider Active NPI

Cody Foeller

  • Pharmacist
  • Saint Charles, MO
National Provider Identifier
1336920362
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2023034545 Issued in MO
Practice address
60 Harvester SQ
Saint Charles, MO 63303-6357
Phone
(636) 441-3300
NPI assigned
Oct 5, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2023034545 MO Primary

Addresses

Primary practice location

60 Harvester SQ
Saint Charles, MO 63303-6357

Mailing address

260 Village Circle Dr
Winfield, MO 63389-2051

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

LicenseStateTypeSpecialty
2023034545MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1696464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1336920362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 VILLAGE CIRCLE DR",
            "city": "WINFIELD",
            "state": "MO",
            "postal_code": "633892051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 HARVESTER SQ",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633036357",
            "telephone_number": "636-441-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOELLER",
        "first_name": "CODY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-05",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2023034545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.