Active NPI
Jay Robert Sutoris, RPH
- Pharmacist
- Raytown, MO
National Provider Identifier
1457628901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2008029243
- Practice address
- 9400 E State Route 350
Raytown, MO 64133-6509 - Phone
- (816) 358-5988
- Fax
- (816) 358-6885
- NPI assigned
- Nov 29, 2011
- 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 | 20063 | IA | |
| Pharmacist | 183500000X | 2008029243 | MO | Primary |
Addresses
Primary practice location
9400 E State Route 350
Raytown, MO 64133-6509
Mailing address
1212 Creekmoor Dr
Raymore, MO 64083-7806
Phone (515) 988-8866
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 |
|---|---|---|---|
| 20063 | IA | MD | Pharmacist |
| 2008029243 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694131200000",
"number": "1457628901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 CREEKMOOR DR",
"city": "RAYMORE",
"state": "MO",
"postal_code": "640837806",
"telephone_number": "515-988-8866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9400 E STATE ROUTE 350",
"city": "RAYTOWN",
"state": "MO",
"postal_code": "641336509",
"telephone_number": "816-358-5988",
"fax_number": "816-358-6885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTORIS",
"first_name": "JAY",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-29",
"last_updated": "2023-09-08",
"certification_date": "2023-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "20063",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2008029243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raytown, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.