Mary Margaret Ellison, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

042428 Issued in MO

Practice address

1490 Mexico Loop Rd E
O Fallon, MO 63366-6015

Phone

(636) 978-1602

NPI assigned

Sep 24, 2011

Last updated

Sep 24, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

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

{
    "created_epoch": "1316822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316822400000",
    "number": "1871876953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MASON RIDGE DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633047283",
            "telephone_number": "636-447-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 MEXICO LOOP RD E",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633666015",
            "telephone_number": "636-978-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "MARY",
        "middle_name": "MARGARET",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-24",
        "last_updated": "2011-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "042428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922013176",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Christine Ekiss, DPT
• Elite Physical Therapy of Ofallon, LLC (CORA Physical Therapy - O'Fallon)
• Dora Ellegood
• Aleasha Elliott, APRN, NP-C
• Savannah Ellis, CPT, CCMA
• Sue Ellison
• Gina Marie Elmendorf, OTR/L
• Taylor Raye Elmore, PT, DPT
• Elpis Pain Management Center LLC
• Jessica Ann Elwell, SLP

• Pharmacist in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2011; 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.