Individual provider Active NPI

Paul Matthew Hueseman, PHARM.D.

  • Pharmacist
  • Saint Louis, MO
National Provider Identifier
1407989734
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
044830 Issued in MO
Practice address
1034 S Brentwood Blvd
Suite 102
Saint Louis, MO 63117-1223
Phone
(314) 727-8787
Fax
(314) 727-2830
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 044830 MO Primary

Addresses

Primary practice location

1034 S Brentwood Blvd
Suite 102
Saint Louis, MO 63117-1223

Mailing address

1034 S Brentwood Blvd
Suite 102
Saint Louis, MO 63117-1223
Phone (314) 727-8787

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

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1407989734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 S BRENTWOOD BLVD",
            "address_2": "SUITE 102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171223",
            "telephone_number": "314-727-8787",
            "fax_number": "314-727-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 S BRENTWOOD BLVD",
            "address_2": "SUITE 102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171223",
            "telephone_number": "314-727-8787",
            "fax_number": "314-727-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUESEMAN",
        "first_name": "PAUL",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "044830",
            "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 Jul 9, 2007; 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.