Individual provider Active NPI

Blake Stickley, RPH

  • Pharmacist
  • Boone, NC
National Provider Identifier
1184469199
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
33120 Issued in NC
Practice address
2184 Blowing Rock Rd
Boone, NC 28607-6154
Phone
(828) 268-0727
NPI assigned
Jul 1, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 33120 NC Primary

Addresses

Primary practice location

2184 Blowing Rock Rd
Boone, NC 28607-6154

Mailing address

2184 Blowing Rock Rd
Boone, NC 28607-6154
Phone (828) 268-0727

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
33120NCMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1184469199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2184 BLOWING ROCK RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286076154",
            "telephone_number": "828-268-0727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2184 BLOWING ROCK RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286076154",
            "telephone_number": "828-268-0727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKLEY",
        "first_name": "BLAKE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "33120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.