Active NPI
Malory Siedle, PHARMD
- Pharmacist
- Saint Louis, MO
National Provider Identifier
1801439971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2015025667
- Practice address
- 4700 N Hanley Rd
Saint Louis, MO 63134-2700 - Phone
- (866) 997-3688
- NPI assigned
- Oct 22, 2019
- 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 | 2015025667 | MO | Primary |
Addresses
Primary practice location
4700 N Hanley Rd
Saint Louis, MO 63134-2700
Mailing address
172 Shortleaf Pine Dr
Cottleville, MO 63304-7610
Phone (636) 359-3708
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 |
|---|---|---|---|
| 2015025667 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571702400000",
"number": "1801439971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "172 SHORTLEAF PINE DR",
"city": "COTTLEVILLE",
"state": "MO",
"postal_code": "633047610",
"telephone_number": "636-359-3708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 N HANLEY RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631342700",
"telephone_number": "866-997-3688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIEDLE",
"first_name": "MALORY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-22",
"last_updated": "2019-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2015025667",
"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 Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.