Individual provider Active NPI

Stacie Atherton, PHARMD

  • Pharmacist
  • Winona, MN
National Provider Identifier
1497364988
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
118153 Issued in MN
Practice address
1122 W Highway 61 Ste a
Winona, MN 55987-1957
Phone
(507) 615-0607
NPI assigned
Jul 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 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 118153 MN Primary

Addresses

Primary practice location

1122 W Highway 61 Ste a
Winona, MN 55987-1957

Mailing address

1122 W Highway 61 Ste a
Winona, MN 55987-1957

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

LicenseStateTypeSpecialty
118153MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc PastSince Aug 2, 2020 Accepting new patients

Organizations & group practices 1

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": "1596067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1497364988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 W HIGHWAY 61 STE A",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559871957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 W HIGHWAY 61 STE A",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559871957",
            "telephone_number": "507-615-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATHERTON",
        "first_name": "STACIE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "118153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winona, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.