Individual provider Active NPI

Marc Sevick, PHARM. D.

  • Pharmacist
  • Saint Louis, MO
National Provider Identifier
1700226370
Registry record updated Jun 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2011026621 Issued in MO
Practice address
4629 Bridlewood Ter
Saint Louis, MO 63128-2205
Phone
(262) 492-7163
NPI assigned
Jun 27, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2011026621 MO Primary
Pharmacist 183500000X 051295374 IL

Addresses

Primary practice location

4629 Bridlewood Ter
Saint Louis, MO 63128-2205

Mailing address

4629 Bridlewood Ter
Saint Louis, MO 63128-2205
Phone (262) 492-7163

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
051295374ILMDPharmacist
2011026621MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1700226370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4629 BRIDLEWOOD TER",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282205",
            "telephone_number": "262-492-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4629 BRIDLEWOOD TER",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282205",
            "telephone_number": "262-492-7163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVICK",
        "first_name": "MARC",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-27",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2011026621",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051295374",
            "primary": false
        }
    ],
    "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 Jun 27, 2013; 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.