Active NPI
Jayesh Patel
- Pharmacist
- Saint Louis, MO
National Provider Identifier
1689951857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2009011793
- Practice address
- 4140 S Broadway
Saint Louis, MO 63118-4604 - Phone
- (314) 832-4995
- NPI assigned
- Nov 15, 2011
- Last updated
- Apr 14, 2015
- 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 | 2009011793 | MO | Primary |
Addresses
Primary practice location
4140 S Broadway
Saint Louis, MO 63118-4604
Mailing address
4140 S Broadway
Saint Louis, MO 63118-4604
Phone (314) 270-8080
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2009011793 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428969600000",
"number": "1689951857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4140 S BROADWAY",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631184604",
"telephone_number": "314-270-8080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4140 S BROADWAY",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631184604",
"telephone_number": "314-832-4995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATEL",
"first_name": "JAYESH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-15",
"last_updated": "2015-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2009011793",
"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 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.