Active NPI
Halley Jo Dorn, PHARMD
- Pharmacist
- Savannah, MO
National Provider Identifier
1740808948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2020020029
- Practice address
- 402 E Price Ave
Savannah, MO 64485-1742 - Phone
- (816) 324-5111
- NPI assigned
- Jul 14, 2020
- Last updated
- Jul 21, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 2020020029 | MO | Primary |
Addresses
Primary practice location
402 E Price Ave
Savannah, MO 64485-1742
Mailing address
896 County Road 28
Bolckow, MO 64427-9658
Phone (402) 440-6589
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2020020029 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595289600000",
"number": "1740808948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "896 COUNTY ROAD 28",
"city": "BOLCKOW",
"state": "MO",
"postal_code": "644279658",
"telephone_number": "402-440-6589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 E PRICE AVE",
"city": "SAVANNAH",
"state": "MO",
"postal_code": "644851742",
"telephone_number": "816-324-5111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORN",
"first_name": "HALLEY",
"middle_name": "JO",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-14",
"last_updated": "2020-07-21",
"certification_date": "2020-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2020020029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Savannah, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.