Active NPI
Katie Kaleen Mahan, PHARM.D.
- Pharmacist
- West Plains, MO
National Provider Identifier
1932703261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 045003
- Practice address
- 1100 N Kentucky Ave
West Plains, MO 65775-2029 - Phone
- (417) 256-1793
- Fax
- (417) 256-1753
- NPI assigned
- Nov 27, 2020
- Last updated
- Feb 12, 2024
- 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 | 045003 | MO | Primary |
Addresses
Primary practice location
1100 N Kentucky Ave
West Plains, MO 65775-2029
Mailing address
18 Parkway Shopping Ctr
West Plains, MO 65775-1840
Phone (417) 256-1793
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.ozarksmedicalcenter.com | Direct |
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045003 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Court Square Pharmacy, Inc | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Theodosia Pharmacy
- Community/Retail Pharmacy
- Theodosia, MO
- NPI 1386706992
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707696000000",
"number": "1932703261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 PARKWAY SHOPPING CTR",
"city": "WEST PLAINS",
"state": "MO",
"postal_code": "657751840",
"telephone_number": "417-256-1793",
"fax_number": "417-256-1784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 N KENTUCKY AVE",
"city": "WEST PLAINS",
"state": "MO",
"postal_code": "657752029",
"telephone_number": "417-256-1793",
"fax_number": "417-256-1753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHAN",
"first_name": "KATIE",
"middle_name": "KALEEN",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-27",
"last_updated": "2024-02-12",
"certification_date": "2024-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "045003",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.ozarksmedicalcenter.com",
"affiliation": "N",
"endpointDescription": "web address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "18 Parkway Shopping Ctr",
"city": "West Plains",
"state": "MO",
"country_code": "US",
"postal_code": "657751840",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in West Plains, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.