Active NPI
Katrina Roberts
- Pharmacist
- Evanston, WY
National Provider Identifier
1154849289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3973
- Practice address
- 70 Yellow Creek Rd
Evanston, WY 82930-5227 - Phone
- (307) 789-0535
- NPI assigned
- Sep 8, 2017
- 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 | 3973 | WY | Primary |
Addresses
Primary practice location
70 Yellow Creek Rd
Evanston, WY 82930-5227
Mailing address
70 Yellow Creek Rd
Evanston, WY 82930-5227
Other names 1
- Katrina Gustafson
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 |
|---|---|---|---|
| 3973 | WY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smith'S Food & Drug Centers Inc | Past | Accepting new patients | |
| Smiths Food & Drug Centers Inc | 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.
-
- Community/Retail Pharmacy
- Evanston, WY
- NPI 1659396281
-
- Community/Retail Pharmacy
- Henderson, NV
- NPI 1881585248
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504828800000",
"number": "1154849289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 YELLOW CREEK RD",
"city": "EVANSTON",
"state": "WY",
"postal_code": "829305227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 YELLOW CREEK RD",
"city": "EVANSTON",
"state": "WY",
"postal_code": "829305227",
"telephone_number": "307-789-0535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "KATRINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-08",
"last_updated": "2017-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WY",
"license": "3973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATRINA",
"last_name": "GUSTAFSON",
"credential": "RPH, PHARMD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Evanston, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.