Individual provider Active NPI

Marina Nicole Maguire

  • Pharmacist
  • Saint Louis, MO
National Provider Identifier
1750042883
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2021050240 Issued in MO
Practice address
4365 Chippewa St
Saint Louis, MO 63116-1606
Phone
(314) 832-2480
Fax
(314) 832-2498
NPI assigned
Dec 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2021050240 MO Primary

Addresses

Primary practice location

4365 Chippewa St
Saint Louis, MO 63116-1606

Mailing address

4365 Chippewa St
Saint Louis, MO 63116-1606
Phone (314) 832-2480

Other identifiers 1

IdentifierTypeStateIssuer
2021050240OtherMOMISSOURI BOARD PHARMACY

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
2021050240MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1750042883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4365 CHIPPEWA ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631161606",
            "telephone_number": "314-832-2480",
            "fax_number": "314-832-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4365 CHIPPEWA ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631161606",
            "telephone_number": "314-832-2480",
            "fax_number": "314-832-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGUIRE",
        "first_name": "MARINA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2021050240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI BOARD PHARMACY",
            "identifier": "2021050240",
            "state": "MO"
        }
    ],
    "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 Dec 30, 2021; 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.