Active NPI
Richard K McMahan
- Pharmacist
- Bridgeton, MO
National Provider Identifier
1902010820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 044134
- Practice address
- 12137 Bridgeton SQ
Bridgeton, MO 63044-2616 - Phone
- (314) 291-5700
- NPI assigned
- May 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 044134 | MO | Primary |
Addresses
Primary practice location
12137 Bridgeton SQ
Bridgeton, MO 63044-2616
Mailing address
3 N Harris Dr
Saint Peters, MO 63376-3504
Phone (636) 397-2169
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
| License | State | Type | Specialty |
|---|---|---|---|
| 044134 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902010820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 N HARRIS DR",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633763504",
"telephone_number": "636-397-2169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12137 BRIDGETON SQ",
"city": "BRIDGETON",
"state": "MO",
"postal_code": "630442616",
"telephone_number": "314-291-5700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMAHAN",
"first_name": "RICHARD",
"middle_name": "K",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "044134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.