Individual provider Active NPI

Renee Ann Stoll, R.PH.

  • Pharmacist
  • Wasilla, AK
National Provider Identifier
1598089799
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19300 Issued in OH
Practice address
3831 E Blue Lupine Drive
Suite a
Wasilla, AK 99654-7185
Phone
(907) 376-5700
Fax
(907) 376-5710
NPI assigned
Mar 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 1030 AK
Pharmacist 183500000X 19300 OH Primary

Addresses

Primary practice location

3831 E Blue Lupine Drive
Suite a
Wasilla, AK 99654-7185

Mailing address

3831 E Blue Lupine Drive
Suite a
Wasilla, AK 99654-7185
Phone (907) 376-5700

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
1030AKMDPharmacist
19300OHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pharmacy Partners, LLC CurrentSince Dec 5, 2021 Accepting new patients
Pharmacy Partners, LLC CurrentSince Jun 16, 2024 Accepting new patients

Locations

3831 E Blue Lupine Dr
#A
Wasilla, AK 99654
Phone (907) 376-5700

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": "1268784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1598089799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3831 E BLUE LUPINE DRIVE",
            "address_2": "SUITE A",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547185",
            "telephone_number": "907-376-5700",
            "fax_number": "907-376-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 E BLUE LUPINE DRIVE",
            "address_2": "SUITE A",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547185",
            "telephone_number": "907-376-5700",
            "fax_number": "907-376-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLL",
        "first_name": "RENEE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AK",
            "license": "1030",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "19300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.