Individual provider Active NPI

Melissa Marie Kroenig, RPH

  • Pharmacist
  • Saint Louis, MO
National Provider Identifier
1902596331
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051290136 Issued in IL
Practice address
621 S New Ballas Rd
Saint Louis, MO 63141-8232
Phone
(314) 251-7444
Fax
(314) 251-7443
NPI assigned
May 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2012009318 MO
Pharmacist 183500000X 051290136 IL Primary

Addresses

Primary practice location

621 S New Ballas Rd
Saint Louis, MO 63141-8232

Mailing address

2405 Lakeshore Dr
Columbia, IL 62236-2685
Phone (618) 420-2325

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
051290136ILMDPharmacist
2012009318MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1902596331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 LAKESHORE DR",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622362685",
            "telephone_number": "618-420-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-7444",
            "fax_number": "314-251-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROENIG",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2012009318",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051290136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.