Individual provider Active NPI

Stacey Johnson, RPH

  • Pharmacist
  • Chillicothe, OH
National Provider Identifier
1053459230
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03-1-18915 Issued in OH
Practice address
311 Caldwell St
Chillicothe, OH 45601-3332
Phone
(740) 775-6242
Fax
(740) 773-0218
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03-1-18915 OH Primary

Addresses

Primary practice location

311 Caldwell St
Chillicothe, OH 45601-3332

Mailing address

106 Limestone Blvd
Chillicothe, OH 45601-1159
Phone (740) 773-7822

Other identifiers 1

IdentifierTypeStateIssuer
03-1-18915OtherOHOHIO PHARMACIST LICENSE

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
Registered Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1053459230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 LIMESTONE BLVD",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456011159",
            "telephone_number": "740-773-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 CALDWELL ST",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456013332",
            "telephone_number": "740-775-6242",
            "fax_number": "740-773-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STACEY",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03-1-18915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO PHARMACIST LICENSE",
            "identifier": "03-1-18915",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chillicothe, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.