Individual provider Active NPI

Stacy R. Hampton, PHARM.D., PA-C

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Lake Oswego, OR
National Provider Identifier
1104016500
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
10115 Issued in OR
Practice address
16869 65TH Ave # 287
Lake Oswego, OR 97035-7865
Phone
(541) 808-1093
Fax
(541) 738-2106
NPI assigned
Jul 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA152548 OR
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 10115 OR Primary

Addresses

Primary practice location

16869 65TH Ave # 287
Lake Oswego, OR 97035-7865

Mailing address

1900 Woodland Dr
Coos Bay, OR 97420-2045
Phone (541) 267-5151

Other names 1

  • Ms. Anastasia R Hampton Other name

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)
Enrolled
Credentials
Physician Assistant, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
10115ORMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1104016500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202045",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16869 65TH AVE # 287",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970357865",
            "telephone_number": "541-808-1093",
            "fax_number": "541-738-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMPTON",
        "first_name": "STACY",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "PHARM.D., PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA152548",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "10115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANASTASIA",
            "last_name": "HAMPTON",
            "middle_name": "R",
            "prefix": "MS.",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.