Active NPI
Christi Lynn Mortimore, PHARMD
- Pharmacist
- Fort Washakie, WY
National Provider Identifier
1346525870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5891
- Practice address
- 29 Black Coal Dr
Fort Washakie, WY 82514 - Phone
- (307) 335-5983
- NPI assigned
- Oct 16, 2011
- Last updated
- Mar 3, 2023
- 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 | 5891 | SD | Primary |
Addresses
Primary practice location
29 Black Coal Dr
Fort Washakie, WY 82514
Mailing address
4809 Southpointe Dr
Rapid City, SD 57701-6310
Phone (605) 545-4999
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5891 | SD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677801600000",
"number": "1346525870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4809 SOUTHPOINTE DR",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577016310",
"telephone_number": "605-545-4999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 BLACK COAL DR",
"city": "FORT WASHAKIE",
"state": "WY",
"postal_code": "82514",
"telephone_number": "307-335-5983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTIMORE",
"first_name": "CHRISTI",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-16",
"last_updated": "2023-03-03",
"certification_date": "2023-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SD",
"license": "5891",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Washakie, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.