Individual provider Active NPI

Mary Louise Hillestad

  • Pharmacist
  • Farmington, MO
National Provider Identifier
1427534361
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
026939 Issued in MO
Practice address
942 Valley Creek Dr
Farmington, MO 63640-1968
Phone
(573) 664-5202
Fax
(573) 664-5203
NPI assigned
Jul 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 026939 MO Primary

Addresses

Primary practice location

942 Valley Creek Dr
Farmington, MO 63640-1968

Mailing address

PO Box 99
French Village, MO 63036-0099
Phone (573) 358-0864

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

LicenseStateTypeSpecialty
026939MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1427534361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "FRENCH VILLAGE",
            "state": "MO",
            "postal_code": "630360099",
            "telephone_number": "573-358-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 VALLEY CREEK DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401968",
            "telephone_number": "573-664-5202",
            "fax_number": "573-664-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLESTAD",
        "first_name": "MARY",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-13",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "026939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.