Active NPI
Stella Lurene Wilson, PHARMD
- Pharmacist
- Ormond Beach, FL
National Provider Identifier
1023708278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS50259
- Practice address
- 129 Barrier Isle Dr
Ormond Beach, FL 32176-2243 - Phone
- (417) 766-5629
- NPI assigned
- May 11, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS50259 | FL | Primary |
| Pharmacist | 183500000X | 2002024557 | MO |
Addresses
Primary practice location
129 Barrier Isle Dr
Ormond Beach, FL 32176-2243
Mailing address
129 Barrier Isle Dr
Ormond Beach, FL 32176-2243
Phone (417) 766-5629
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 |
|---|---|---|---|
| PS50259 | FL | MD | Pharmacist |
| 2002024557 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683763200000",
"number": "1023708278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 BARRIER ISLE DR",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321762243",
"telephone_number": "417-766-5629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 BARRIER ISLE DR",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321762243",
"telephone_number": "417-766-5629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "STELLA",
"middle_name": "LURENE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-11",
"last_updated": "2023-05-11",
"certification_date": "2023-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS50259",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2002024557",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ormond Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.