Stephanie Russo Godwin, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

22465 Issued in MD

Practice address

2132 Old Snow Hill Rd
Pocomoke City, MD 21851-2734

Phone

(410) 726-2117

NPI assigned

Oct 27, 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

Other names 1

• Stephanie Mae Russo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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

{
    "created_epoch": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1427658806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4424 STOCKTON RD",
            "city": "POCOMOKE CITY",
            "state": "MD",
            "postal_code": "218512512",
            "telephone_number": "410-726-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2132 OLD SNOW HILL RD",
            "city": "POCOMOKE CITY",
            "state": "MD",
            "postal_code": "218512734",
            "telephone_number": "410-726-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODWIN",
        "first_name": "STEPHANIE",
        "middle_name": "RUSSO",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "22465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "RUSSO",
            "middle_name": "MAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pharmacist in Pocomoke City, MD
• Providers in Pocomoke City, MD by specialty
• Pharmacist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.