Active NPI
Paul Gustin
- Pharmacist
- Saint Peters, MO
National Provider Identifier
1457791287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2012034118
- Practice address
- 6211 Mid Rivers Mall Dr
Saint Peters, MO 63304-1102 - Phone
- (636) 936-3020
- NPI assigned
- Jun 25, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2012034118 | MO | Primary |
Addresses
Primary practice location
6211 Mid Rivers Mall Dr
Saint Peters, MO 63304-1102
Mailing address
6211 Mid Rivers Mall Dr
Saint Peters, MO 63304-1102
Phone (636) 936-3020
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2012034118 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372118400000",
"number": "1457791287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6211 MID RIVERS MALL DR",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633041102",
"telephone_number": "636-936-3020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6211 MID RIVERS MALL DR",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633041102",
"telephone_number": "636-936-3020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSTIN",
"first_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-25",
"last_updated": "2013-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2012034118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peters, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.