Individual provider Active NPI

Stacy Freiss, PHARMD

  • Pharmacist
  • Colorado Springs, CO
National Provider Identifier
1013285261
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16335 Issued in CO
Practice address
3201 E Platte Ave
Colorado Springs, CO 80909-6408
Phone
(719) 578-0380
NPI assigned
Dec 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16335 CO Primary

Addresses

Primary practice location

3201 E Platte Ave
Colorado Springs, CO 80909-6408

Mailing address

4296 Aryshire LN
Colorado Springs, CO 80922-3711
Phone (719) 578-0380

Other practice location 1

2431 N Union Blvd
Colorado Springs, CO 80909-1107
Phone (719) 630-3154

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

LicenseStateTypeSpecialty
16335COMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Ave Apothecary LLC PastSince Jul 25, 2019 Accepting new patients
Park Ave Apothecary LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1013285261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4296 ARYSHIRE LN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809223711",
            "telephone_number": "719-578-0380",
            "fax_number": "719-578-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 E PLATTE AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809096408",
            "telephone_number": "719-578-0380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2431 N Union Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809091107",
            "country_code": "US",
            "telephone_number": "719-630-3154",
            "fax_number": "719-630-1640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREISS",
        "first_name": "STACY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "16335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.