Active NPI
Monique Martin
- Pharmacist
- Brentwood, MO
National Provider Identifier
1982291829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 045313
- Practice address
- 25 Brentwood Promenade CT
Brentwood, MO 63144-1428 - Phone
- (314) 918-1939
- NPI assigned
- Dec 27, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 016638 | LA | |
| Pharmacist | 183500000X | 045313 | MO | Primary |
Addresses
Primary practice location
25 Brentwood Promenade CT
Brentwood, MO 63144-1428
Mailing address
7029 Etzel Ave
Saint Louis, MO 63130-2458
Phone (314) 721-4370
Other practice location 1
7029 Etzel Ave
Saint Louis, MO 63130-2458
Phone (314) 721-4370
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nicholas.buccheit@cvshealth.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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045313 | MO | MD | Pharmacist |
| 016638 | LA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609027200000",
"number": "1982291829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7029 ETZEL AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631302458",
"telephone_number": "314-721-4370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 BRENTWOOD PROMENADE CT",
"city": "BRENTWOOD",
"state": "MO",
"postal_code": "631441428",
"telephone_number": "314-918-1939"
}
],
"practiceLocations": [
{
"address_1": "7029 Etzel Ave",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631302458",
"country_code": "US",
"telephone_number": "314-721-4370",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTIN",
"first_name": "MONIQUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-27",
"last_updated": "2020-12-27",
"certification_date": "2020-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "016638",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "045313",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nicholas.buccheit@cvshealth.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "25 Brentwood Promenade Ct",
"city": "Brentwood",
"state": "MO",
"country_code": "US",
"postal_code": "631441428",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Brentwood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.