Individual provider Active NPI

Staci Guidry, RPH

  • Pharmacist
  • Lake Charles, LA
National Provider Identifier
1447797477
Registry record updated Jan 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PST.021891 Issued in LA
Practice address
366 Sam Houston Jones Pkwy
Lake Charles, LA 70611-5602
Phone
(337) 855-1341
NPI assigned
Jan 29, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PST.021891 LA Primary

Addresses

Primary practice location

366 Sam Houston Jones Pkwy
Lake Charles, LA 70611-5602

Mailing address

1401 Waverly St
Lake Charles, LA 70605-6139
Phone (337) 526-2077

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
PST.021891LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana CVS Pharmacy, L.L.C. Past Accepting new patients
CVS/Caremark Past 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": "1485648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485648000000",
    "number": "1447797477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 WAVERLY ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706056139",
            "telephone_number": "337-526-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 SAM HOUSTON JONES PKWY",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706115602",
            "telephone_number": "337-855-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUIDRY",
        "first_name": "STACI",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-29",
        "last_updated": "2017-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST.021891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2017; 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.