Active NPI
Blessin Mathew
- Pharmacist
- Springfield, MO
National Provider Identifier
1952684490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2009004997
- Practice address
- 1930 W Grand St
Springfield, MO 65802-4870 - Phone
- (417) 863-6416
- Fax
- (417) 863-1286
- NPI assigned
- Sep 21, 2011
- Last updated
- Sep 21, 2011
- Sex
- Female
- 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 | 2009004997 | MO | Primary |
Addresses
Primary practice location
1930 W Grand St
Springfield, MO 65802-4870
Mailing address
5619 N 11TH Ave
Ozark, MO 65721-8009
Phone (417) 576-1994
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 |
|---|---|---|---|
| 2009004997 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316563200000",
"number": "1952684490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5619 N 11TH AVE",
"city": "OZARK",
"state": "MO",
"postal_code": "657218009",
"telephone_number": "417-576-1994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 W GRAND ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658024870",
"telephone_number": "417-863-6416",
"fax_number": "417-863-1286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEW",
"first_name": "BLESSIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-21",
"last_updated": "2011-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2009004997",
"primary": true
}
],
"identifiers": [],
"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 Sep 21, 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.