Active NPI
Kevin Eugene Bruce, RPH
- Pharmacist
- Fenton, MO
National Provider Identifier
1598047409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 041565
- Practice address
- 1210 Sugar Creek
Fenton, MO 63026 - Phone
- (636) 326-5113
- NPI assigned
- Sep 16, 2011
- Last updated
- Sep 16, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 041565 | MO | Primary |
Addresses
Primary practice location
1210 Sugar Creek
Fenton, MO 63026
Mailing address
11 Worthy CT
Fenton, MO 63026
Phone (636) 225-5797
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
- Registered 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": "1316131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316131200000",
"number": "1598047409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 WORTHY CT",
"city": "FENTON",
"state": "MO",
"postal_code": "63026",
"telephone_number": "636-225-5797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 SUGAR CREEK",
"city": "FENTON",
"state": "MO",
"postal_code": "63026",
"telephone_number": "636-326-5113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCE",
"first_name": "KEVIN",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-16",
"last_updated": "2011-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "041565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fenton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.