Active NPI
Dylan McDonald, PHARMD
- Pharmacist
- Florissant, MO
National Provider Identifier
1508555467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2021031828
- Practice address
- 1550 S New Florissant Rd
Florissant, MO 63031-8123 - Phone
- (314) 830-3282
- NPI assigned
- May 4, 2023
- Last updated
- May 4, 2023
- 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 | 2021031828 | MO | Primary |
Addresses
Primary practice location
1550 S New Florissant Rd
Florissant, MO 63031-8123
Mailing address
6230 Loughborough Ave Apt 1W
Saint Louis, MO 63109-3637
Phone (913) 850-2283
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021031828 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Missouri CVS Pharmacy LLC | Past | Accepting new patients | |
| Missouri CVS Pharmacy LLC | 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": "1683158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683158400000",
"number": "1508555467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6230 LOUGHBOROUGH AVE APT 1W",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631093637",
"telephone_number": "913-850-2283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1550 S NEW FLORISSANT RD",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630318123",
"telephone_number": "314-830-3282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "DYLAN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-04",
"last_updated": "2023-05-04",
"certification_date": "2023-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2021031828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florissant, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.