Active NPI
Shannon Lea Waltsgott, R.PH
- Pharmacist
- Saint Louis, MO
National Provider Identifier
1356623813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2003020549
- Practice address
- 7199 Natural Bridge Rd
Saint Louis, MO 63121-5143 - Phone
- (314) 382-9926
- Fax
- (314) 382-1278
- NPI assigned
- Sep 12, 2011
- 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 | 2003020549 | MO | Primary |
Addresses
Primary practice location
7199 Natural Bridge Rd
Saint Louis, MO 63121-5143
Mailing address
2725 Fairway Dr
Belleville, IL 62220-4859
Phone (618) 416-1091
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2003020549 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315785600000",
"number": "1356623813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2725 FAIRWAY DR",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622204859",
"telephone_number": "618-416-1091",
"fax_number": "314-382-1278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7199 NATURAL BRIDGE RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631215143",
"telephone_number": "314-382-9926",
"fax_number": "314-382-1278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTSGOTT",
"first_name": "SHANNON",
"middle_name": "LEA",
"credential": "R.PH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-12",
"last_updated": "2011-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2003020549",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.