Individual provider Active NPI

Harrison Austin Perdew, PHARMD

  • Pharmacist
  • Raymore, MO
National Provider Identifier
1730781659
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2017037464 Issued in MO
Practice address
1215 W Foxwood Dr
Raymore, MO 64083-8301
Phone
(816) 318-8022
Fax
(816) 331-3253
NPI assigned
Nov 16, 2020
Last updated
Nov 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 1-15833 KS
Pharmacist 183500000X 2017037464 MO Primary

Addresses

Primary practice location

1215 W Foxwood Dr
Raymore, MO 64083-8301

Mailing address

1215 W Foxwood Dr
Raymore, MO 64083-8301
Phone (816) 318-8022

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
1-15833KSMDPharmacist
2017037464MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1730781659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 W FOXWOOD DR",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "640838301",
            "telephone_number": "816-318-8022",
            "fax_number": "816-331-3253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 W FOXWOOD DR",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "640838301",
            "telephone_number": "816-318-8022",
            "fax_number": "816-331-3253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDEW",
        "first_name": "HARRISON",
        "middle_name": "AUSTIN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-15833",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2017037464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raymore, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.