Individual provider Active NPI

Jeffrey Kleine, PHARMD

  • Pharmacist
  • Manchester, MO
National Provider Identifier
1659951002
Registry record updated Apr 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2015033398 Issued in MO
Practice address
301 Highlands Boulevard Dr
Manchester, MO 63011-4385
Phone
(636) 686-7409
Fax
(636) 686-7406
NPI assigned
Apr 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2015033398 MO Primary

Addresses

Primary practice location

301 Highlands Boulevard Dr
Manchester, MO 63011-4385

Mailing address

17704 Wilding Place Dr
Wildwood, MO 63005-4279
Phone (314) 922-0985

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
2015033398MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1618012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618012800000",
    "number": "1659951002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17704 WILDING PLACE DR",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630054279",
            "telephone_number": "314-922-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HIGHLANDS BOULEVARD DR",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630114385",
            "telephone_number": "636-686-7409",
            "fax_number": "636-686-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEINE",
        "first_name": "JEFFREY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-10",
        "last_updated": "2021-04-10",
        "certification_date": "2021-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2015033398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2021; 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.