Individual provider Active NPI

Cholly Alldredge

  • Pharmacist
  • Saint Peters, MO
National Provider Identifier
1831539550
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
043323 Issued in MO
Practice address
6211 Mid Rivers Mall Dr
Saint Peters, MO 63304-1102
Phone
(636) 936-3020
NPI assigned
Jun 26, 2013
Last updated
Jun 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 043323 MO Primary

Addresses

Primary practice location

6211 Mid Rivers Mall Dr
Saint Peters, MO 63304-1102

Mailing address

6211 Mid Rivers Mall Dr
Saint Peters, MO 63304-1102
Phone (636) 936-3020

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
043323MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1831539550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6211 MID RIVERS MALL DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633041102",
            "telephone_number": "636-936-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6211 MID RIVERS MALL DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633041102",
            "telephone_number": "636-936-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLDREDGE",
        "first_name": "CHOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "043323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.