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CVS PHARMACY #11309
NPI 1376621557
Pharmacy in Excelsior Springs, MO

Active since November 02, 2006CLIA 26D2226053 · Waiver
1018 N JESSE JAMES RD, EXCELSIOR SPRINGS, MO 64024(816) 637-5555 Get Directions Write a Review

NPPES record last updated: September 6, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 6, 2018, Aug 8, 2018, Jul 3, 2018 and 1 more (4 updates tracked since 2018).

About Cvs Pharmacy #11309 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CVS PHARMACY #11309 (NPI 1376621557) is a healthcare organization registered as a pharmacy in Excelsior Springs, Missouri and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through May 25, 2027 and lists Susan Colbert, Sr. Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1376621557
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameMISSOURI CVS PHARMACY, L.L.C.
Location Address1018 N JESSE JAMES RDExcelsior Springs, MO 64024
Mailing Address1 Cvs Drive, Box 1075Woonsocket, RI 02895-6146 · (401) 765-1500 · Fax (660) 886-6320
Phone(816) 637-5555
Organization SubpartNo
Authorized OfficialSusan ColbertSr. Director, Payer Relations · (401) 770-2751
Enumeration DateNovember 2, 2006
Last NPPES UpdateSeptember 6, 20184 updates tracked since enumeration
✔ NPI 1376621557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
1018 N JESSE JAMES RD, Excelsior Springs, MO 64024
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Other Names 1

Doing Business AsCvs Pharmacy #11309

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cvs Pharmacy #11309 is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMissouriEnrollment IDO20180817001017DME · PharmacyDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2226053

Missouri CVS Pharmacy, LLC Dba Cvs/Pharmacy #11309 · Excelsior Springs, MO
Active · expires May 25, 2027
CLIA Number26D2226053
Laboratory TypePharmacy
Certificate Effective DateMay 26, 2025
Certificate Expiration DateMay 25, 2027
Laboratory DirectorDanielle Karlin
Laboratory Phone(866) 389-2727
Laboratory LocationMissouri CVS Pharmacy, LLC Dba Cvs/Pharmacy #113091018 N Jesse James Rd, Excelsior Springs, MO 64024
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
123 services123 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
112 services112 patients

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories CVS Pharmacy #11309 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #11309

DMEPOS supplier · Excelsior Springs, MOOperated by Missouri CVS Pharmacy LLC
✔

Accepts Medicare assignment

CVS Pharmacy #11309 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20322389
Medicare Participant SinceJanuary 1, 2023
Supplier Location1018 N Jesse James RdExcelsior Springs, MO 64024
Phone(816) 637-5555
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHRISTA TETUAN PHARM.D.
Pharmacist
1018 N JESSE JAMES RD
EXCELSIOR SPRINGS, MO 64024
Clay County (816) 637-5555
KATHRYN HARTLEY PHARM.D.
Pharmacist
1018 N JESSE JAMES RD
EXCELSIOR SPRINGS, MO 64024
Clay County (816) 637-5555
AMANDA JOHNSON PHARM D
Pharmacist
1018 N JESSE JAMES RD
EXCELSIOR SPRINGS, MO 64024
Clay County (816) 637-5555
MRS. JANE ANN MULLINS RPH
Pharmacist
1018 N JESSE JAMES RD
EXCELSIOR SPRINGS, MO 64024
Clay County (816) 637-5555

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Missouri CVS Pharmacy, L.L.C.'s NPI number?

The NPI number for Missouri CVS Pharmacy, L.L.C. is 1376621557. It was assigned to this organization in the NPPES registry on November 2, 2006. The provider is doing business as CVS Pharmacy #11309.

Where is Missouri CVS Pharmacy, L.L.C. located?

Missouri CVS Pharmacy, L.L.C. is located at 1018 N Jesse James Rd, Excelsior Springs, MO 64024. The listed phone number is (816) 637-5555.

What is Missouri CVS Pharmacy, L.L.C.'s specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Is Missouri CVS Pharmacy, L.L.C. enrolled in Medicare?

Yes. Missouri CVS Pharmacy, L.L.C. is registered in the Medicare PECOS enrollment system.

When is Missouri CVS Pharmacy, L.L.C.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Missouri, Pharmacy) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Missouri CVS Pharmacy, L.L.C. accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, CVS Pharmacy #11309 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Missouri CVS Pharmacy, L.L.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2226053) is associated with this NPI, valid through May 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Missouri CVS Pharmacy, L.L.C. accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 33 other insurers list Missouri CVS Pharmacy, L.L.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Missouri CVS Pharmacy, L.L.C. was last updated on September 6, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.