NIKHAT BANU, DO — NPI 1174490643 (Licensed & Credentialed Suppliers — Pharmacy, Mail Order Pharmacy in CHESTERFIELD, MO)

CMS-1500 Box 24J / 33a • NPI

1174490643

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

3336M0002X (CMS 58)

Licensed & Credentialed Suppliers — Pharmacy, Mail Order Pharmacy

Box 32 Service Location & ZIP+4

400 S WOODS MILL RD STE 100, CHESTERFIELD, MO, 63017-3427

✓ 9-Digit EDI 837 ZIP+4 (63017-3427)

Practice Phone & Referral Fax

(844) 963-0320

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1174490643 (NIKHAT BANU, DO) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1174490643` (NPI-1 Individual Practitioner)
Provider / Legal Name	NIKHAT BANU, DO
Plain-English Specialty	Licensed & Credentialed Suppliers — Pharmacy, Mail Order Pharmacy NUCC Code: `3336M0002X` (Pharmacy, Mail Order Pharmacy)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	400 S WOODS MILL RD STE 100, CHESTERFIELD, MO, 63017-3427
Practice Telephone / Fax	Tel: (844) 963-0320
Administrative Mailing Address	423 AVA RENEE DR, MANCHESTER, MO, 63021-5184
Enumeration & Last Sync	Enumerated: 2025-10-20 \| CMS Record Updated: 2025-10-20

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

400 S WOODS MILL RD STE 100, CHESTERFIELD, MO, 63017-3427

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Plain-English Taxonomy & CMS Crosswalk (3336M0002X)

What Does Taxonomy Code 3336M0002X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3336M0002X translates to:
"Licensed & Credentialed Suppliers — Pharmacy, Mail Order Pharmacy"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 58 (Medical Supply Company with Pharmacist) • CMS Code A5 (Pharmacy)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Pharmacy, Mail Order Pharmacy for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (NIKHAT BANU, DO)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`3336M0002X` — Pharmacy, Mail Order Pharmacy Plain English: Licensed & Credentialed Suppliers — Pharmacy, Mail Order Pharmacy	State: MO \| License: `2025040299` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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NIKHAT BANU, DO (NPI #1174490643)