NPIMap

Organization Active NPI

St John's Regional Health Center

Doing business as St John's Pharmacy-Nixa

  • Pharmacist
  • Nixa, MO
National Provider Identifier
1518150150
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2005012026 Issued in MO
Legal business name
ST JOHN'S REGIONAL HEALTH CENTER
Doing business as
St John's Pharmacy-Nixa
Practice address
940 W Mount Vernon St
Suite 130
Nixa, MO 65714-9609
Phone
(417) 724-5350
Fax
(417) 724-5354
NPI assigned
Aug 27, 2007
Last updated
Nov 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jay Guffey
Title
Coo
Phone
(417) 820-2520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2005012026 MO Primary

Addresses

Primary practice location

940 W Mount Vernon St
Suite 130
Nixa, MO 65714-9609

Mailing address

940 W Mount Vernon St
Suite 130
Nixa, MO 65714-9609
Phone (417) 724-5350

Other identifiers 1

IdentifierTypeStateIssuer
626198402MedicaidMO

Other names 1

  • St John's Pharmacy-Nixa Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St John's Regional Health Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

940 W Mount Vernon St
Ste 130
Nixa, MO 65714
Phone (417) 724-5340

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1518150150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 W MOUNT VERNON ST",
            "address_2": "SUITE 130",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149609",
            "telephone_number": "417-724-5350",
            "fax_number": "417-724-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 W MOUNT VERNON ST",
            "address_2": "SUITE 130",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149609",
            "telephone_number": "417-724-5350",
            "fax_number": "417-724-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHN'S REGIONAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "GUFFEY",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "417-820-2520",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2005012026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "626198402",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St John's Pharmacy-Nixa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nixa, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.