Active NPI
Thomas Jackson Stark Jr., PHARMD
- Pharmacist
- Bridgeport, WV
National Provider Identifier
1487941381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP0007086
- Practice address
- 327 Medical Park Dr
Bridgeport, WV 26330-9006 - Phone
- (681) 342-1580
- NPI assigned
- Jun 30, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | RP0007086 | WV | Primary |
Addresses
Primary practice location
327 Medical Park Dr
Bridgeport, WV 26330-9006
Mailing address
327 Medical Park Dr
Bridgeport, WV 26330-9006
Phone (681) 342-1580
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 |
|---|---|---|---|
| RP0007086 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375488000000",
"number": "1487941381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "327 MEDICAL PARK DR",
"city": "BRIDGEPORT",
"state": "WV",
"postal_code": "263309006",
"telephone_number": "681-342-1580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "327 MEDICAL PARK DR",
"city": "BRIDGEPORT",
"state": "WV",
"postal_code": "263309006",
"telephone_number": "681-342-1580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARK",
"first_name": "THOMAS",
"middle_name": "JACKSON",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-30",
"last_updated": "2013-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0007086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.