NPIMap

Individual provider Active NPI

Samuel A Okoronkwo, PHARMACIST

  • Pharmacist
  • Christiansburg, VA
National Provider Identifier
1104107770
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
009212 Issued in VA
Practice address
555 N Franklin St
Christiansburg, VA 24073-1949
Phone
(540) 381-8713
Fax
(540) 381-8717
NPI assigned
Sep 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 29851 TX
Pharmacist 183500000X 0004788 WV
Pharmacist 183500000X 009212 VA Primary

Addresses

Primary practice location

555 N Franklin St
Christiansburg, VA 24073-1949

Mailing address

555 N Franklin St
Christiansburg, VA 24073-1949
Phone (540) 381-8713

Other names 1

  • Dr. Stella E Bassey 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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
29851TXMDPharmacist
009212VAMDPharmacist
0004788WVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kroger Limited Partnership I Past Accepting new patients
Kroger Limited Partnership I 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1104107770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N FRANKLIN ST",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240731949",
            "telephone_number": "540-381-8713",
            "fax_number": "540-381-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N FRANKLIN ST",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240731949",
            "telephone_number": "540-381-8713",
            "fax_number": "540-381-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKORONKWO",
        "first_name": "SAMUEL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-08",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "29851",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WV",
            "license": "0004788",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "009212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STELLA",
            "last_name": "BASSEY",
            "middle_name": "E",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Christiansburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; 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.