Individual provider Active NPI

Marla Marie Musso, PHARM.D

  • Pharmacist
  • Maryville, IL
National Provider Identifier
1962785691
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051295295 Issued in IL
Practice address
6607 State Route 162
Maryville, IL 62062-8514
Phone
(618) 288-2130
NPI assigned
Sep 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051295295 IL Primary

Addresses

Primary practice location

6607 State Route 162
Maryville, IL 62062-8514

Mailing address

6607 State Route 162
Maryville, IL 62062-8514
Phone (618) 288-2130

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

LicenseStateTypeSpecialty
051295295ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1962785691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6607 STATE ROUTE 162",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628514",
            "telephone_number": "618-288-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6607 STATE ROUTE 162",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628514",
            "telephone_number": "618-288-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSSO",
        "first_name": "MARLA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051295295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

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

Verify at the official NPI Registry.