Active NPI
Marielle Fares
- Pharmacist
- Staunton, VA
National Provider Identifier
1104507979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH100000321
- Practice address
- 505 Fraser LN
Staunton, VA 24401-2334 - Phone
- (202) 213-9182
- NPI assigned
- Jul 26, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH100000321 | DC | Primary |
| Pharmacist | 183500000X | 0202215867 | VA |
Addresses
Primary practice location
505 Fraser LN
Staunton, VA 24401-2334
Mailing address
505 Fraser LN
Staunton, VA 24401-2334
Phone (202) 213-9182
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 |
|---|---|---|---|
| PH100000321 | DC | MD | Pharmacist |
| 0202215867 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766016000000",
"number": "1104507979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 FRASER LN",
"city": "STAUNTON",
"state": "VA",
"postal_code": "244012334",
"telephone_number": "202-213-9182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 FRASER LN",
"city": "STAUNTON",
"state": "VA",
"postal_code": "244012334",
"telephone_number": "202-213-9182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARES",
"first_name": "MARIELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-26",
"last_updated": "2025-12-18",
"certification_date": "2025-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "DC",
"license": "PH100000321",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202215867",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staunton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.