Individual provider Active NPI

Kristi Ann Sisk

  • Pharmacist
  • Saint Louis, MO
National Provider Identifier
1699279265
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
043463 Issued in MO
Practice address
5937 W Florissant Ave
Saint Louis, MO 63136-4952
Phone
(314) 553-9573
Fax
(314) 953-9572
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 043463 MO Primary

Addresses

Primary practice location

5937 W Florissant Ave
Saint Louis, MO 63136-4952

Mailing address

3438 Erman Ave
Bridgeton, MO 63044-3072
Phone (314) 609-8247

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
043463MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1699279265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3438 ERMAN AVE",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630443072",
            "telephone_number": "314-609-8247",
            "fax_number": "314-553-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5937 W FLORISSANT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631364952",
            "telephone_number": "314-553-9573",
            "fax_number": "314-953-9572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISK",
        "first_name": "KRISTI",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "043463",
            "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 Mar 20, 2018; 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.