Active NPI
Gary Charles Paul, RPH
- Pharmacist
- Missouri Valley, IA
National Provider Identifier
1447522271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17473
- Practice address
- 2414 335TH St
Missouri Valley, IA 51555-8070 - Phone
- (712) 310-9136
- NPI assigned
- Feb 9, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17473 | IA | Primary |
| Pharmacist | 183500000X | 12293 | NE |
Addresses
Primary practice location
2414 335TH St
Missouri Valley, IA 51555-8070
Mailing address
2414 335TH St
Missouri Valley, IA 51555-8070
Phone (712) 310-9136
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17473 | IA | MD | Pharmacist |
| 12293 | NE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328745600000",
"number": "1447522271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2414 335TH ST",
"city": "MISSOURI VALLEY",
"state": "IA",
"postal_code": "515558070",
"telephone_number": "712-310-9136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2414 335TH ST",
"city": "MISSOURI VALLEY",
"state": "IA",
"postal_code": "515558070",
"telephone_number": "712-310-9136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAUL",
"first_name": "GARY",
"middle_name": "CHARLES",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-09",
"last_updated": "2012-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "17473",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "12293",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Missouri Valley, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.