Corey Lynn Davis, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

2012025402 Issued in MO

Practice address

4401 W Pine Blvd
Saint Louis, MO 63108-2301

Phone

(314) 533-1081

Fax

(314) 533-1082

NPI assigned

Dec 20, 2020

Sex

Female

Sole proprietor

No

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": "1608422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608422400000",
    "number": "1962098301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3042 CROATIA DR",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622364175",
            "telephone_number": "618-830-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 W PINE BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082301",
            "telephone_number": "314-533-1081",
            "fax_number": "314-533-1082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Lynch St",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631181818",
            "country_code": "US",
            "telephone_number": "314-669-9701",
            "fax_number": "314-669-9704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "COREY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-20",
        "last_updated": "2020-12-20",
        "certification_date": "2020-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2012025402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Gentry Davis Jr., D.M.D.
• Chelsea Maria Davis, LCSW
• Christopher Phillip Davis, MD
• Clayton Luke Davis, MD
• Colleen Marie Davis, SLP-CCC
• Courtney Davis, OTR/L
• Danielle Davis, M.D.
• Davon Marsean Davis, PHARM D
• Deondra Davis
• Diane Davis, MA, PLPC

• Pharmacist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.