Active NPI
Clinton James Hoffman, PHARMD
- Pharmacist
- Saint Louis, MO
National Provider Identifier
1386927747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2005031047
- Practice address
- 8000 Saint Charles Rock Rd
Saint Louis, MO 63114-5364 - Phone
- (314) 426-1044
- NPI assigned
- Sep 22, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2005031047 | MO | Primary |
| Pharmacist | 183500000X | 5385 | SD |
Addresses
Primary practice location
8000 Saint Charles Rock Rd
Saint Louis, MO 63114-5364
Mailing address
1079 Reddington Timbers Dr
Saint Charles, MO 63304-5063
Phone (314) 922-4055
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6039664 | Medicaid | MO |
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005031047 | MO | MD | Pharmacist |
| 5385 | SD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 1
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": "1316649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316649600000",
"number": "1386927747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1079 REDDINGTON TIMBERS DR",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633045063",
"telephone_number": "314-922-4055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8000 SAINT CHARLES ROCK RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631145364",
"telephone_number": "314-426-1044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOFFMAN",
"first_name": "CLINTON",
"middle_name": "JAMES",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-22",
"last_updated": "2011-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2005031047",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SD",
"license": "5385",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6039664",
"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 Sep 22, 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.