Individual provider Active NPI

Patricia Lynn Stevens, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Agana Heights, GU
National Provider Identifier
1275246340
Registry record updated Feb 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
P10468 Issued in ID
Practice address
498 Chalan Palosyo
Agana Heights, GU 96910-6427
Phone
(808) 214-1306
NPI assigned
Jan 3, 2023
Last updated
Feb 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P10468 ID
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 033.0135038 VT
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X P10468 ID Primary

Addresses

Primary practice location

498 Chalan Palosyo
Agana Heights, GU 96910-6427

Mailing address

425 Chalan San Antonio
PMB 347
Tamuning, GU 96913

Other practice location 1

459 Patterson Rd
Honolulu, HI 96819-1522
Phone (808) 433-0600

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
P10468IDMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
033.0135038VTMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707523200000",
    "number": "1275246340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 CHALAN SAN ANTONIO",
            "address_2": "PMB 347",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "96913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 CHALAN PALOSYO",
            "city": "AGANA HEIGHTS",
            "state": "GU",
            "postal_code": "969106427",
            "telephone_number": "808-214-1306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "459 Patterson Rd",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968191522",
            "country_code": "US",
            "telephone_number": "808-433-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "PATRICIA",
        "middle_name": "LYNN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-03",
        "last_updated": "2024-02-10",
        "certification_date": "2024-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P10468",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "VT",
            "license": "033.0135038",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "ID",
            "license": "P10468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agana Heights, GU

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.