Active NPI
Mark Charles Stephens, PHARMACIST
- Pharmacist
- Orwigsburg, PA
National Provider Identifier
1053489401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3279
- Practice address
- 297 Drehersville Rd
Orwigsburg, PA 17961-9603 - Phone
- (570) 640-1094
- NPI assigned
- Dec 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3279 | ME | Primary |
| Pharmacist | 183500000X | RP029878L | PA | |
| Pharmacist | 183500000X | 033.0003897 | VT | |
| Pharmacist | 183500000X | PCT.0011235 | CT | |
| Pharmacist | 183500000X | PH232445 | MA |
Addresses
Primary practice location
297 Drehersville Rd
Orwigsburg, PA 17961-9603
Mailing address
297 Drehersville Rd
Orwigsburg, PA 17961-9603
Phone (570) 640-1094
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 |
|---|---|---|---|
| PCT.0011235 | CT | MD | Pharmacist |
| PH232445 | MA | MD | Pharmacist |
| 3279 | ME | MD | Pharmacist |
| RP029878L | PA | MD | Pharmacist |
| 033.0003897 | VT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342742400000",
"number": "1053489401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "297 DREHERSVILLE RD",
"city": "ORWIGSBURG",
"state": "PA",
"postal_code": "179619603",
"telephone_number": "570-640-1094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "297 DREHERSVILLE RD",
"city": "ORWIGSBURG",
"state": "PA",
"postal_code": "179619603",
"telephone_number": "570-640-1094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "MARK",
"middle_name": "CHARLES",
"name_prefix": "Mr.",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-02",
"last_updated": "2012-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ME",
"license": "3279",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP029878L",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VT",
"license": "033.0003897",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0011235",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH232445",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orwigsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.