Individual provider Active NPI

Mark Sly, PHARMD

  • Geriatric Pharmacist
  • Saint Louis, MO
National Provider Identifier
1679848618
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric PharmacistTaxonomy code 1835G0303X
License
051295174 Issued in IL
Practice address
1 Jefferson Barracks Dr
Saint Louis, MO 63125-4181
Phone
(309) 663-8852
NPI assigned
Mar 8, 2012
Last updated
Apr 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Pharmacist 1835G0303X 051295174 IL Primary

Addresses

Primary practice location

1 Jefferson Barracks Dr
Saint Louis, MO 63125-4181

Mailing address

1 Jefferson Barracks Dr
Saint Louis, MO 63125-4181

Other practice location 1

915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone (314) 652-4100

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
051295174ILMDGeriatric Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1679848618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254181",
            "telephone_number": "309-663-8852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "915 N Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631061621",
            "country_code": "US",
            "telephone_number": "314-652-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLY",
        "first_name": "MARK",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-08",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "IL",
            "license": "051295174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; 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.