Individual provider Active NPI

Darrell James Shirk

  • Pharmacist
  • Versailles, MO
National Provider Identifier
1992910442
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2003000273 Issued in MO
Practice address
901 Kidwell Dr
Versailles, MO 65084-1784
Phone
(573) 378-4661
Fax
(573) 378-5053
NPI assigned
May 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2003000273 MO Primary

Addresses

Primary practice location

901 Kidwell Dr
Versailles, MO 65084-1784

Mailing address

177 Greenes PT
Gravois Mills, MO 65037-8024
Phone (573) 374-6882

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

LicenseStateTypeSpecialty
2003000273MOMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992910442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 GREENES PT",
            "city": "GRAVOIS MILLS",
            "state": "MO",
            "postal_code": "650378024",
            "telephone_number": "573-374-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 KIDWELL DR",
            "city": "VERSAILLES",
            "state": "MO",
            "postal_code": "650841784",
            "telephone_number": "573-378-4661",
            "fax_number": "573-378-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRK",
        "first_name": "DARRELL",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2003000273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Versailles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.