Individual provider Active NPI

Chad Lundstrum, PHARMD

  • Pharmacist
  • Joplin, MO
National Provider Identifier
1811304587
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
MO2011033285 Issued in MO
Practice address
1001 S Range Line Rd
Joplin, MO 64801-5585
Phone
(417) 782-4802
NPI assigned
Jul 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X MO2011033285 MO Primary

Addresses

Primary practice location

1001 S Range Line Rd
Joplin, MO 64801-5585

Mailing address

1001 S Range Line Rd
Joplin, MO 64801-5585
Phone (417) 782-4802

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
MO2011033285MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dillon Companies LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1811304587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S RANGE LINE RD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648015585",
            "telephone_number": "417-782-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S RANGE LINE RD",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648015585",
            "telephone_number": "417-782-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDSTRUM",
        "first_name": "CHAD",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-15",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "MO2011033285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; 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.