Active NPI
Sean Michael O'Bannon
- Pharmacist
- Saint Louis, MO
National Provider Identifier
1366922932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2016025435
- Practice address
- 4700 N Hanley Rd
Saint Louis, MO 63134-2700 - Phone
- (866) 997-3688
- NPI assigned
- Aug 14, 2018
- 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 | 2016025435 | MO | Primary |
Addresses
Primary practice location
4700 N Hanley Rd
Saint Louis, MO 63134-2700
Mailing address
4700 N Hanley Rd
Saint Louis, MO 63134-2700
Phone (866) 997-3688
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2016025435 | Other | MO | PHARMACIST LICENSE |
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 |
|---|---|---|---|
| 2016025435 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534204800000",
"number": "1366922932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 N HANLEY RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631342700",
"telephone_number": "866-997-3688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 N HANLEY RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631342700",
"telephone_number": "866-997-3688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'BANNON",
"first_name": "SEAN",
"middle_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-14",
"last_updated": "2018-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2016025435",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "2016025435",
"state": "MO"
}
],
"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 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.