Individual provider Active NPI

Jean R Tenholder, RPH

  • Pharmacist
  • Saint Louis, MO
National Provider Identifier
1366726945
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
040758 Issued in MO
Practice address
9890 Clayton Rd Ste 125
Saint Louis, MO 63124-1644
Phone
(314) 227-0995
NPI assigned
Sep 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051.290806 IL
Pharmacist 183500000X 040758 MO Primary

Addresses

Primary practice location

9890 Clayton Rd Ste 125
Saint Louis, MO 63124-1644

Mailing address

9890 Clayton Rd
Saint Louis, MO 63124-1685
Phone (314) 631-2285

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

LicenseStateTypeSpecialty
051.290806ILMDPharmacist
040758MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Genoa Healthcare LLC PastSince Aug 23, 2020 Accepting new patients
Genoa Healthcare LLC PastSince Aug 23, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1366726945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9890 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241685",
            "telephone_number": "314-631-2285",
            "fax_number": "314-963-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9890 CLAYTON RD STE 125",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631241644",
            "telephone_number": "314-227-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENHOLDER",
        "first_name": "JEAN",
        "middle_name": "R",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-30",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.290806",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "040758",
            "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 Aug 19, 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.

Verify at the official NPI Registry.