Active NPI
Stacy Valencia Samuel, PHARM D
- Pharmacist
- Harrisburg, NC
National Provider Identifier
1124319884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15673
- Practice address
- 4305 NC Highway 49
Harrisburg, NC 28075 - Phone
- (704) 454-5920
- NPI assigned
- Apr 28, 2011
- Last updated
- Apr 28, 2011
- Sex
- Female
- Sole proprietor
- No
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 | 15673 | NC | Primary |
Addresses
Primary practice location
4305 NC Highway 49
Harrisburg, NC 28075
Mailing address
11215 Gold Pan Rd
Charlotte, NC 28215-8622
Phone (704) 502-8052
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15673 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303948800000",
"number": "1124319884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11215 GOLD PAN RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282158622",
"telephone_number": "704-502-8052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4305 NC HIGHWAY 49",
"city": "HARRISBURG",
"state": "NC",
"postal_code": "28075",
"telephone_number": "704-454-5920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "STACY",
"middle_name": "VALENCIA",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-28",
"last_updated": "2011-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "15673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrisburg, NC
- Ryan Londry & David Modlin II DDS PLLC (Harrisburg Dental)
- Shaheen Shawn Safaie
- Safrit PLLC (Family Dental Health of Harrisburg)
- Sal C Zammitti DMD MMSC PLLC and Matthew P Gidaly DDS PLLC III (Zammitti & Gidaly Orthodontics)
- Sal C Zammitti DMD MMSC PLLC and Matthew P Gidaly DDS PLLC VIII (NC Tooth Docs- Harrisburg Kids Dentistry)
- Resat Say, DDS
- Jessica Schneebaum, FNP
- Halie Scott, DMD
- Tamara Scott, PHD
- Andrew Segarra, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.