Individual provider Active NPI

Cristal Marie Totterman, PHARMD

  • Pharmacist
  • Stuart, FL
National Provider Identifier
1144838103
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS46419 Issued in FL
Practice address
3754 SE Ocean Blvd Ste B
Stuart, FL 34996-6700
Phone
(772) 600-8077
NPI assigned
Jul 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS46419 FL Primary

Addresses

Primary practice location

3754 SE Ocean Blvd Ste B
Stuart, FL 34996-6700

Mailing address

3754 SE Ocean Blvd Ste B
Stuart, FL 34996-6700
Phone (727) 600-8077

Other identifiers 1

IdentifierTypeStateIssuer
PS46419OtherFLSTATE BOARD OF PHARMACY

Other names 1

  • Cristal Marie Randall Former 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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS46419FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sewall'S Point Pharmacy Inc CurrentSince Jul 1, 2020 Accepting new patients

Locations

3754 SE Ocean Blvd
Ste B
Stuart, FL 34996
Phone (772) 600-8077

Organizations & group practices 1

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": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1144838103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3754 SE OCEAN BLVD STE B",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349966700",
            "telephone_number": "727-600-8077",
            "fax_number": "772-600-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3754 SE OCEAN BLVD STE B",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349966700",
            "telephone_number": "772-600-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOTTERMAN",
        "first_name": "CRISTAL",
        "middle_name": "MARIE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-16",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS46419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF PHARMACY",
            "identifier": "PS46419",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTAL",
            "last_name": "RANDALL",
            "middle_name": "MARIE",
            "credential": "PHARMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.