Stephanie Jaderko, PHARM.D

Primary specialty

PharmacistTaxonomy code 183500000X

License

2017031095 Issued in MO

Practice address

1001 Bowles Ave
Fenton, MO 63026-2338

Phone

(636) 343-0754

NPI assigned

Aug 12, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1922619089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6236 N LAKESHORE DR",
            "city": "BYRNES MILL",
            "state": "MO",
            "postal_code": "630511119",
            "telephone_number": "314-703-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BOWLES AVE",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262338",
            "telephone_number": "636-343-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JADERKO",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2017031095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Id Med Consulting, Inc
• Intensivist Group of Missouri Inc
• Christopher William Jackson, D.O.
• Tracie Marie Jackson, RPH
• Edward V. Jacquin, P. T.
• Sue E Jagler, MD
• Susan James, FNP
• Zaynab Jamil
• Jay F. Hauser, DDS, PC (Premier Dental Partners)
• Jessica C. Nieva DDS P.C.

• Pharmacist in Fenton, MO
• Providers in Fenton, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.