Mikell Stevenson, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

11118 Issued in SC

Practice address

720 E Front St
Iva, SC 29655-9089

Phone

(864) 348-6138

NPI assigned

Dec 4, 2023

Last updated

Dec 4, 2023By the provider in NPPES

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

Credentials

Doctor of Pharmacy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Iva Drug Store, Inc.

  • Community/Retail Pharmacy
  • Iva, SC
  • NPI 1770588097
  NPD (past)

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1407622244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 KEONE CIR",
            "city": "WILLIAMSTON",
            "state": "SC",
            "postal_code": "296979243",
            "telephone_number": "864-617-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E FRONT ST",
            "city": "IVA",
            "state": "SC",
            "postal_code": "296559089",
            "telephone_number": "864-348-6138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Hillcrest Dr",
            "address_purpose": "LOCATION",
            "city": "Easley",
            "state": "SC",
            "postal_code": "296401221",
            "country_code": "US",
            "telephone_number": "864-642-4879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "MIKELL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "11118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Brown Purdy, RN
• Lauren Rearden, OTR/L
• SC-Ga2018 Iva Rehabilitation and Healthcare Center, LLC (Iva Rehabilitation and Healthcare Center)
• Shawntea N Scott
• Becky Shank, L.I.S.W
• Annabeth Watkins, PT
• Willow Creek Living Center, LLC

• Pharmacist in Iva, SC
• Providers in Iva, SC by specialty
• Pharmacist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.

Verify at the official NPI Registry.