Cody Overmann, PHARM. D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

051.299539 Issued in IL

Practice address

100 Admiral Trost Rd
Columbia, IL 62236-1996

Phone

(618) 281-6400

NPI assigned

Nov 26, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Highland Park CVS, L.L.C.

  • Pharmacy
  • Columbia, IL
  • NPI 1558464222
  NPD (past)

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

{
    "created_epoch": "1606348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606348800000",
    "number": "1609470970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ADMIRAL TROST RD",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361996",
            "telephone_number": "618-281-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ADMIRAL TROST RD",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361996",
            "telephone_number": "618-281-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERMANN",
        "first_name": "CODY",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-26",
        "last_updated": "2020-11-26",
        "certification_date": "2020-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.299539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "051.299539",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Columbia",
            "affiliation": "N",
            "address_1": "100 Admiral Trost Rd",
            "city": "Columbia",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622361996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Columbia, IL
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2020; 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.