Active NPI
Stacey Nicole Zysk, PHARMD
- Pharmacist
- Salem, VA
National Provider Identifier
1629741863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202219765
- Practice address
- 1970 Roanoke Blvd
Salem, VA 24153-6404 - Phone
- (540) 982-2463
- NPI assigned
- Jul 25, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 0202219765 | VA | Primary |
Addresses
Primary practice location
1970 Roanoke Blvd
Salem, VA 24153-6404
Mailing address
108 Hidden Valley Rd
New Castle, VA 24127-6196
Phone (540) 589-9173
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 |
|---|---|---|---|
| 0202219765 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627171200000",
"number": "1629741863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 HIDDEN VALLEY RD",
"city": "NEW CASTLE",
"state": "VA",
"postal_code": "241276196",
"telephone_number": "540-589-9173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1970 ROANOKE BLVD",
"city": "SALEM",
"state": "VA",
"postal_code": "241536404",
"telephone_number": "540-982-2463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZYSK",
"first_name": "STACEY",
"middle_name": "NICOLE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-25",
"last_updated": "2021-07-25",
"certification_date": "2021-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202219765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.