Active NPI
Ryan M Hestily, PHARMACIST
- Pharmacist
- Calera, OK
National Provider Identifier
1003659202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13026
- Practice address
- 213 E Main St Ste 100
Calera, OK 74730-2116 - Phone
- (580) 448-2315
- NPI assigned
- Jun 15, 2024
- Last updated
- Jun 15, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13026 | OK | Primary |
Addresses
Primary practice location
213 E Main St Ste 100
Calera, OK 74730-2116
Mailing address
1002 Kirsey Rd
Calera, OK 74730-5125
Phone (580) 920-9510
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13026 | OK | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718409600000",
"number": "1003659202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1002 KIRSEY RD",
"city": "CALERA",
"state": "OK",
"postal_code": "747305125",
"telephone_number": "580-920-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "213 E MAIN ST STE 100",
"city": "CALERA",
"state": "OK",
"postal_code": "747302116",
"telephone_number": "580-448-2315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HESTILY",
"first_name": "RYAN",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-15",
"last_updated": "2024-06-15",
"certification_date": "2024-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "13026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Calera, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.