Active NPI
Trae Michael Meny
- Pharmacist
- Hannibal, MO
National Provider Identifier
1356254528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2026046687
- Practice address
- 3603 McMasters Ave
Hannibal, MO 63401-2541 - Phone
- (573) 719-3122
- NPI assigned
- Sep 28, 2026
- Last updated
- Sep 28, 2026
- 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 | 2026046687 | MO | Primary |
Addresses
Primary practice location
3603 McMasters Ave
Hannibal, MO 63401-2541
Mailing address
3603 McMasters Ave
Hannibal, MO 63401-2541
Phone (573) 721-4079
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 |
|---|---|---|---|
| 2026046687 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Missouri CVS Pharmacy LLC | Past | Accepting new patients | |
| Missouri CVS Pharmacy LLC | 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": "1790553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790553600000",
"number": "1356254528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3603 MCMASTERS AVE",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "634012541",
"telephone_number": "573-721-4079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3603 MCMASTERS AVE",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "634012541",
"telephone_number": "573-719-3122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENY",
"first_name": "TRAE",
"middle_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-09-28",
"last_updated": "2026-09-28",
"certification_date": "2026-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2026046687",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hannibal, MO
- Raegan Mencer
- Mennonite Home Association Inc. (Beth Haven Nursing Home)
- Mennonite Home Association Inc. (The Haven Homes)
- Mennonite Home Association Inc. (Pleasant View)
- Mennonite Home Association, Inc (Pleasant View)
- Schuyler Cole Metlis, M.D.
- E Sean Meyer, MA, LCSW
- Janis Meyers
- Michael E McKenzie Jr, DDS LLC
- Jessica Nichole Mickels, RNFA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.