KAYLA REVERMANN (NPI# 1326648155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326648155 |
| Entity Type | Individual |
| Full Name | KAYLA REVERMANN |
| Practice Address |
1350 W Us Highway 50 Pharmacy O Fallon IL 62269 |
| Practice Telephone | 6186220507 |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 2016011547 | MO | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 051298647 | IL | Pharmacy Service Providers |
| Street Address |
1350 W US HIGHWAY 50 PHARMACY |
| City | O FALLON |
| State | IL |
| Zip Code | 62269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942814272 | Ashley Monique Gibson | Behavior Technician | Eagle Center, Ste 10, Ofallon, IL 62269 | 2020-09-03 |
| 1013533819 | Michelle Denise Voudrie | Registered Nurse | 321 Regency Park, O'fallon, IL 62269 | 2020-06-18 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1962063800 | Gerald Paskert | Pharmacist | 122 W. State St., O'fallon, IL 62269 | 2019-06-21 |
| 1780144808 | Bonnie Jean Lampe | Physical Therapy Assistant | 316 Donna Dr, O'fallon, IL 62269 | 2019-03-24 |
| 1134633993 | Latisha Smith | Psychologist | 600 S. Smiley St., O'fallon, IL 62269 | 2017-11-30 |
| 1619407210 | Brenna M Thomas | Registered Nurse | 1310 Engle Ct, O'fallon, IL 62269 | 2017-06-15 |
| 1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
| 1700230539 | Jennifer Farrell | Family Medicine | 3 St. Elizabeth's Blvd, Ste. 4000, O'fallon, IL 62269 | 2016-04-18 |
| 1700270816 | Kristen Kapalka Griffin | Obstetrics & Gynecology | 1170 Fortune Blvd, Shiloh, IL 62269 | 2015-03-26 |
| Find all providers in zip 62269 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376194134 | Michael Charles Cornwall | Pharmacist | 21 Shallowbrook Dr, O Fallon, IL 62269-1214 | 2019-09-24 |
| 1023594249 | Brandon Frey | Pharmacist | 907 E Highway 50, O Fallon, IL 62269-2856 | 2018-07-11 |
| 1235677170 | Shannon Carlisle | Pharmacist | 2605 Mclean Ct, O Fallon, MO 63368-7611 | 2017-02-10 |
| 1558702050 | Katherine Michelle Derickson | Pharmacist | 247 Pheasant Point Blvd, O Fallon, MO 63368-7311 | 2013-07-12 |
| 1013262039 | Charles Smith | Pharmacist | 601 W Falls Ct, O Fallon, MO 63368-9646 | 2012-07-16 |
| 1457626384 | Jennifer Conrad | Pharmacist | 7776 Winghaven Blvd, O Fallon, MO 63368-3601 | 2012-03-10 |
| 1891071668 | Lisa L Houston | Pharmacist | 24 Sterling Crossing Ct, O Fallon, MO 63368-7367 | 2011-10-25 |
| 1053694158 | Walgreens | Pharmacist | 106 Huntington Crossing Dr, O Fallon, MO 63376-4271 | 2011-09-25 |
| 1366725616 | Anthony P Webb | Pharmacist | 801 Highway K, O Fallon, MO 63366-2996 | 2011-09-23 |
| 1447531645 | Rachel Romano | Pharmacist | 4650 Highway K, O Fallon, MO 63368-8728 | 2011-08-31 |
| Find all providers in O FALLON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.