OrganizationActive
St. John'S Physician & Clinic
NPI 1790978765 · Pharmacist · Licking, MO
St. John'S Physician & Clinic is a Pharmacist organization in Licking, MO (NPI 1790978765).
Provider details
- NPI number
- 1790978765
- Entity type
- Organization
- Primary specialty
- PharmacistPharmacy Service Providers
- Organization subpart
- No
- Authorized official
- Rob Shockley, Retail Coordinator(417) 820-6624
- License
- 006040 (MO)
Specialties & taxonomies
Pharmacy Service Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
101 North Main Street
Licking, MO 65542
Phone: (573) 674-2922
Fax: (573) 674-4334
Street-level locationGet directions
Mailing address
101 North Main Street
Licking, MO 65542
Other names (DBA / former)
- Doing business as
- St. John'S Sisk Pharmacy
Registry dates
- Enumerated
- 2007-08-23
- Last updated
- 2007-08-23
Frequently asked questions
- What is St. John'S Physician & Clinic's NPI number?
- St. John'S Physician & Clinic's National Provider Identifier (NPI) is 1790978765, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is St. John'S Physician & Clinic?
- St. John'S Physician & Clinic is classified in the NPPES registry as Pharmacist (Pharmacy Service Providers).
- Where is St. John'S Physician & Clinic located?
- St. John'S Physician & Clinic's practice location on file with NPPES is 101 North Main Street, Licking, MO 65542.
- What is St. John'S Physician & Clinic's phone number?
- The practice phone number listed in the NPPES registry for St. John'S Physician & Clinic is (573) 674-2922.
- Who is the authorized official for St. John'S Physician & Clinic?
- The authorized official listed on St. John'S Physician & Clinic's NPPES record is Rob Shockley, Retail Coordinator. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is St. John'S Physician & Clinic's NPI active?
- Yes — St. John'S Physician & Clinic's NPI (1790978765) is active in the NPPES registry as of the last update on 2007-08-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.