Individual provider Active NPI

Evan J Strake, PHARM D

  • Pharmacist
  • Saint Louis, MO
National Provider Identifier
1548818305
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2019032323 Issued in MO
Practice address
11550 Page Service Dr
Saint Louis, MO 63146-3509
Phone
(314) 344-9201
NPI assigned
Aug 26, 2019
Last updated
Aug 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2019032323 MO Primary

Addresses

Primary practice location

11550 Page Service Dr
Saint Louis, MO 63146-3509

Mailing address

1591 Mary Todd LN
O Fallon, IL 62269-6676
Phone (618) 660-5442

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

LicenseStateTypeSpecialty
2019032323MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1548818305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1591 MARY TODD LN",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622696676",
            "telephone_number": "618-660-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11550 PAGE SERVICE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463509",
            "telephone_number": "314-344-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRAKE",
        "first_name": "EVAN",
        "middle_name": "J",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2019032323",
            "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 Aug 26, 2019; 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.