Active NPI
Johnathan Doty
- Pharmacist
- Saint Louis, MO
National Provider Identifier
1497472922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2022042508
- Practice address
- 4218 Lindell Blvd
Saint Louis, MO 63108-2916 - Phone
- (314) 371-4286
- NPI assigned
- Oct 25, 2022
- 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 | 2022042508 | MO | Primary |
Addresses
Primary practice location
4218 Lindell Blvd
Saint Louis, MO 63108-2916
Mailing address
4218 Lindell Blvd
Saint Louis, MO 63108-2916
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 |
|---|---|---|---|
| 2022042508 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666656000000",
"number": "1497472922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4218 LINDELL BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631082916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4218 LINDELL BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631082916",
"telephone_number": "314-371-4286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOTY",
"first_name": "JOHNATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-25",
"last_updated": "2022-10-25",
"certification_date": "2022-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2022042508",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.