Active NPI
Collette Wiley, RPH
- Pharmacist
- Springfield, MO
National Provider Identifier
1912285107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 044549
- Practice address
- 440 E Tampa St
Springfield, MO 65806-1131 - Phone
- (417) 831-0150
- Fax
- (417) 863-8756
- NPI assigned
- Jul 22, 2011
- Sex
- Female
- Sole proprietor
- No
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 | 044549 | MO | Primary |
Addresses
Primary practice location
440 E Tampa St
Springfield, MO 65806-1131
Mailing address
440 E Tampa St
Springfield, MO 65806-1131
Phone (417) 831-0150
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FEDERAL TAX ID | Other | MO | 43-1602701 |
| NCPDP | Other | MO | 2619522 |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 044549 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311292800000",
"number": "1912285107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 E TAMPA ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658061131",
"telephone_number": "417-831-0150",
"fax_number": "417-863-8756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "440 E TAMPA ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658061131",
"telephone_number": "417-831-0150",
"fax_number": "417-863-8756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "COLLETTE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-22",
"last_updated": "2011-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "044549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "43-1602701",
"identifier": "FEDERAL TAX ID",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "2619522",
"identifier": "NCPDP",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.