Active NPI
Stefanie Leigh Raitt, PHARMD, PHC
- Pharmacotherapy Pharmacist
- Albuquerque, NM
National Provider Identifier
1003997404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 5583
- Practice address
- 1100 Central Ave SE
Albuquerque, NM 87106-4930 - Phone
- (505) 681-4154
- Fax
- (505) 724-6024
- NPI assigned
- Oct 18, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 5583 | NM | Primary |
Addresses
Primary practice location
1100 Central Ave SE
Albuquerque, NM 87106-4930
Mailing address
1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone (505) 681-4154
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5583 | NM | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003997404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 CENTRAL AVE SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064930",
"telephone_number": "505-681-4154",
"fax_number": "505-724-6024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 CENTRAL AVE SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064930",
"telephone_number": "505-681-4154",
"fax_number": "505-724-6024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAITT",
"first_name": "STEFANIE",
"middle_name": "LEIGH",
"credential": "PHARMD, PHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "NM",
"license": "5583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.