NPIMap

Individual provider Active NPI

Stanley Akimbom, PHARMACIST

  • Pharmacist
  • The Colony, TX
National Provider Identifier
1609439223
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PST.022913 Issued in LA
Practice address
6749 Main St
The Colony, TX 75056-1647
Phone
(972) 625-3207
NPI assigned
Apr 18, 2019
Last updated
Jan 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PST.022913 LA Primary
Pharmacist 183500000X 64031 TX

Addresses

Primary practice location

6749 Main St
The Colony, TX 75056-1647

Mailing address

1100 Rutherford St
Frisco, TX 75036-0957
Phone (262) 753-3871

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address str.05181@walgreens.com Direct

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

State licenses

LicenseStateTypeSpecialty
PST.022913LAMDPharmacist
64031TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
CVS Pharmacy Inc PastSince Feb 1, 2022 Accepting new patients
Walgreen Co Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: str.05181@walgreens.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1609439223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 RUTHERFORD ST",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750360957",
            "telephone_number": "262-753-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6749 MAIN ST",
            "city": "THE COLONY",
            "state": "TX",
            "postal_code": "750561647",
            "telephone_number": "972-625-3207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKIMBOM",
        "first_name": "STANLEY",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-18",
        "last_updated": "2022-01-25",
        "certification_date": "2021-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST.022913",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "64031",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "str.05181@walgreens.com",
            "affiliation": "N",
            "endpointDescription": "str.05181@walgreens.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3555 Greenwood Rd",
            "city": "Shreveport",
            "state": "LA",
            "country_code": "US",
            "postal_code": "711095209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in The Colony, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.