Individual provider Active NPI

John Martin Eddins, RPH

  • Pharmacist
  • Lees Summit, MO
National Provider Identifier
1861093577
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2000154894 Issued in MO
Practice address
1000 NE Sam Walton LN
Lees Summit, MO 64086-8426
Phone
(816) 246-4555
NPI assigned
Nov 9, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2000154894 MO Primary

Addresses

Primary practice location

1000 NE Sam Walton LN
Lees Summit, MO 64086-8426

Mailing address

5457 NE Northgate Xing
Lees Summit, MO 64064-1231
Phone (816) 529-8492

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
2000154894MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1861093577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5457 NE NORTHGATE XING",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640641231",
            "telephone_number": "816-529-8492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NE SAM WALTON LN",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640868426",
            "telephone_number": "816-246-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDINS",
        "first_name": "JOHN",
        "middle_name": "MARTIN",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2000154894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.

Verify at the official NPI Registry.