Individual provider Active NPI

Julie Simmerman, PHARM D

  • Pharmacist
  • Maryville, MO
National Provider Identifier
1629348362
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2011023703 Issued in MO
Practice address
125 E South Ave
Maryville, MO 64468-2669
Phone
(660) 562-2300
NPI assigned
Jan 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2011023703 MO Primary

Addresses

Primary practice location

125 E South Ave
Maryville, MO 64468-2669

Mailing address

1114 S Main St
Maryville, MO 64468-2602
Phone (660) 562-2157

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
2011023703MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1629348362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 S MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682602",
            "telephone_number": "660-562-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E SOUTH AVE",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682669",
            "telephone_number": "660-562-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMERMAN",
        "first_name": "JULIE",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2011023703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.

Verify at the official NPI Registry.