Justin C Stakston, PHARMD, BCPS

Primary specialty

Pharmacotherapy PharmacistTaxonomy code 1835P1200X

License

14519-40 Issued in WI

Practice address

2400 Rose St
La Crosse, WI 54603-1612

Phone

(608) 781-3300

NPI assigned

Apr 28, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Shopko Stores Operating Co LLC

  • Community/Retail Pharmacy
  • La Crosse, WI
  • NPI 1790731438
  NPD (past)
• Shopko Stores Operating Co. LLC

  • Eyewear Supplier
  • Albert Lea, MN
  • NPI 1528010642
  NPD (past)

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1174933295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 ROSE ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546031612",
            "telephone_number": "608-781-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ROSE ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546031612",
            "telephone_number": "608-781-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAKSTON",
        "first_name": "JUSTIN",
        "middle_name": "C",
        "credential": "PHARMD, BCPS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-28",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "WI",
            "license": "14519-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Clare Health Mission Pharmacy
• Jennifer L St. John, RPH
• Stephen Kimball Stacey, DO
• Barbara J Stafslien, APNP
• Heidi Stair, OT
• Carrie Stamp, RN
• Zoran Stancic, MD
• Erica Jean Stanek, D.D.S.
• Monica B Stanek, NP
• Amanda Nikole Stanick

• Pharmacotherapy Pharmacist in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Pharmacotherapy Pharmacist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; 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.