Stacey Lee Williston

Primary specialty

PharmacistTaxonomy code 183500000X

License

11445 Issued in OK

Practice address

700 W Rogers Blvd
Skiatook, OK 74070-1035

Phone

(918) 396-3194

Fax

(918) 396-3211

NPI assigned

Nov 17, 2020

Sex

Female

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

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.

• Wal-Mart Stores East LP

  • Community/Retail Pharmacy
  • Skiatook, OK
  • NPI 1417974536
  NPD (past)

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1336742154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W ROGERS BLVD",
            "city": "SKIATOOK",
            "state": "OK",
            "postal_code": "740701035",
            "telephone_number": "918-396-3194",
            "fax_number": "918-396-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 W ROGERS BLVD",
            "city": "SKIATOOK",
            "state": "OK",
            "postal_code": "740701035",
            "telephone_number": "918-396-3194",
            "fax_number": "918-396-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLISTON",
        "first_name": "STACEY",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "11445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheri L. White, CNS
• Nellie Dawn Whitlatch-Crooks
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• Bradford Raymond Williams, D.D.S.
• Bradford Raymond Williams II, DDS

• Pharmacist in Skiatook, OK
• Providers in Skiatook, OK by specialty
• Pharmacist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.