Individual provider Active NPI

Lynn Diane Stover, RPH

  • Pharmacist
  • Wichita, KS
National Provider Identifier
1124308747
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
1-13254 Issued in KS
Practice address
5611 E Harry St
Wichita, KS 67218-3801
Phone
(316) 684-5864
Fax
(316) 684-5262
NPI assigned
Aug 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 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 1-13254 KS Primary
Pharmacist 183500000X 18762 IA
Pharmacist 183500000X 051.293273 IL

Addresses

Primary practice location

5611 E Harry St
Wichita, KS 67218-3801

Mailing address

5611 E Harry St
Wichita, KS 67218-3801
Phone (316) 684-5864

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
18762IAMDPharmacist
051.293273ILMDPharmacist
1-13254KSMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1124308747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5611 E HARRY ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672183801",
            "telephone_number": "316-684-5864",
            "fax_number": "316-684-5262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5611 E HARRY ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672183801",
            "telephone_number": "316-684-5864",
            "fax_number": "316-684-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVER",
        "first_name": "LYNN",
        "middle_name": "DIANE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-26",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KS",
            "license": "1-13254",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "18762",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.293273",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.