Active NPI
Statia Cordle
- Pharmacist
- New Lexington, OH
National Provider Identifier
1053846683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03-3-21610
- Practice address
- 610 Carroll St
New Lexington, OH 43764-1051 - Phone
- (740) 342-5649
- Fax
- (740) 342-5651
- NPI assigned
- Apr 20, 2017
- Last updated
- Apr 20, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03-3-21610 | OH | Primary |
Addresses
Primary practice location
610 Carroll St
New Lexington, OH 43764-1051
Mailing address
11700 Avalon Rd
Rushville, OH 43150-9665
Phone (740) 342-5649
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Co | Past | Accepting new patients | |
| The Kroger Co | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492646400000",
"number": "1053846683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11700 AVALON RD",
"city": "RUSHVILLE",
"state": "OH",
"postal_code": "431509665",
"telephone_number": "740-342-5649",
"fax_number": "740-342-5651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 CARROLL ST",
"city": "NEW LEXINGTON",
"state": "OH",
"postal_code": "437641051",
"telephone_number": "740-342-5649",
"fax_number": "740-342-5651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDLE",
"first_name": "STATIA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-20",
"last_updated": "2017-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03-3-21610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Lexington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.