Active NPI
Mike Gregory, RPH
- Pharmacist
- Fulton, MO
National Provider Identifier
1669790606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 40838
- Practice address
- 600 Court St
Fulton, MO 65251-1903 - Phone
- (573) 642-6892
- Fax
- (573) 642-9447
- NPI assigned
- May 15, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 40838 | MO | Primary |
Addresses
Primary practice location
600 Court St
Fulton, MO 65251-1903
Mailing address
5001 E Deer Noll Rd
Columbia, MO 65201-9785
Phone (573) 442-5454
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40838 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273881600000",
"number": "1669790606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5001 E DEER NOLL RD",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652019785",
"telephone_number": "573-442-5454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 COURT ST",
"city": "FULTON",
"state": "MO",
"postal_code": "652511903",
"telephone_number": "573-642-6892",
"fax_number": "573-642-9447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGORY",
"first_name": "MIKE",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-15",
"last_updated": "2010-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "40838",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fulton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.