NPIMap

Individual provider Active NPI

Joshua Chambliss

  • Pharmacist
  • Granite City, IL
National Provider Identifier
1649546557
Registry record updated Mar 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051295300 Issued in IL
Practice address
3655 Nameoki Rd
Granite City, IL 62040-3710
Phone
(618) 451-9490
Fax
(618) 451-1122
NPI assigned
Mar 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051295300 IL Primary

Addresses

Primary practice location

3655 Nameoki Rd
Granite City, IL 62040-3710

Mailing address

3655 Nameoki Rd
Granite City, IL 62040-3710
Phone (618) 451-9490

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

State licenses

LicenseStateTypeSpecialty
051295300ILMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
5 Guys RX LLC Current Accepting new patients
5 Guysrx 3 LLC Current 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": "1332633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332633600000",
    "number": "1649546557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3655 NAMEOKI RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620403710",
            "telephone_number": "618-451-9490",
            "fax_number": "618-451-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 NAMEOKI RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620403710",
            "telephone_number": "618-451-9490",
            "fax_number": "618-451-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBLISS",
        "first_name": "JOSHUA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-25",
        "last_updated": "2012-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051295300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2012; 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.