Individual provider Active NPI

Stacey James Shirley, R.PH.

  • Pharmacist
  • Huntsville, TX
National Provider Identifier
1386259125
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
31981 Issued in TX
Practice address
2601 11TH St
Huntsville, TX 77340-3728
Phone
(936) 435-1234
Fax
(936) 435-0178
NPI assigned
Sep 9, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 31981 TX Primary

Addresses

Primary practice location

2601 11TH St
Huntsville, TX 77340-3728

Mailing address

2601 11TH St
Huntsville, TX 77340-3728
Phone (936) 435-1234

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
31981TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Brookshire Brothers Inc PastSince Sep 13, 2020 Accepting new patients
Brookshire Brothers Inc PastSince Sep 13, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1386259125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 11TH ST",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773403728",
            "telephone_number": "936-435-1234",
            "fax_number": "936-435-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 11TH ST",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773403728",
            "telephone_number": "936-435-1234",
            "fax_number": "936-435-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "STACEY",
        "middle_name": "JAMES",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "31981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.