Active NPI
Mark Salem
- Pharmacist
- Saint Peters, MO
National Provider Identifier
1497341119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2019045835
- Practice address
- 530 Mid Rivers Mall Dr
Saint Peters, MO 63376-2150 - Phone
- (636) 970-3222
- NPI assigned
- Dec 16, 2020
- 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 | 2019045835 | MO | Primary |
Addresses
Primary practice location
530 Mid Rivers Mall Dr
Saint Peters, MO 63376-2150
Mailing address
4320 Chouteau Ave # 2F
Saint Louis, MO 63110-1606
Phone (314) 757-8380
Other practice location 1
4320 Chouteau Ave # 2F
Saint Louis, MO 63110-1606
Phone (314) 757-8380
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 |
|---|---|---|---|
| 2019045835 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608076800000",
"number": "1497341119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4320 CHOUTEAU AVE # 2F",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101606",
"telephone_number": "314-757-8380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 MID RIVERS MALL DR",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633762150",
"telephone_number": "636-970-3222"
}
],
"practiceLocations": [
{
"address_1": "4320 Chouteau Ave # 2F",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631101606",
"country_code": "US",
"telephone_number": "314-757-8380",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SALEM",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-16",
"last_updated": "2020-12-16",
"certification_date": "2020-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2019045835",
"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 Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.