Crystal Le-Ann Dornbach-Poojari, PHARM. D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

2010028707 Issued in MO

Practice address

4430 Missouri Ave
Fort Leonard Wood, MO 65473-9098

Phone

(573) 596-0514

NPI assigned

Apr 19, 2010

Last updated

Dec 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Crystal Le-Ann Blackburn Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1639495419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 TRACI DAWN DR",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654018259",
            "telephone_number": "314-365-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098",
            "telephone_number": "573-596-0514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNBACH-POOJARI",
        "first_name": "CRYSTAL",
        "middle_name": "LE-ANN",
        "credential": "PHARM. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-19",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2010028707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "email",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "person",
            "address_1": "4430 Missouri Ave",
            "city": "Fort Leonard Wood",
            "state": "MO",
            "country_code": "US",
            "postal_code": "654739098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "email",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "person",
            "address_1": "4430 Missouri Ave",
            "city": "Fort Leonard Wood",
            "state": "MO",
            "country_code": "US",
            "postal_code": "654739098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "BLACKBURN",
            "middle_name": "LE-ANN",
            "credential": "PHARM D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kodjo Adam Dodo, RD
• Brock Justin Dodsworth, PTA
• Jessica Dolan, RDN
• Justin Marshall Dominguez, DPT
• Maria Mercedes Dominguez, PHD, LMFT
• Candice Renee Douglas, FNP-C
• Derek Bradley Douglas, D.O.
• Patrick Lee Downing Jr., RDN
• Reagan Drebenstedt, DNP
• Zaine Robert Dugan

• Pharmacist in Fort Leonard Wood, MO
• Providers in Fort Leonard Wood, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.