Individual provider Active NPI

Conrad D Stumpf

  • Pharmacist
  • Wayne, NJ
National Provider Identifier
1639694474
Registry record updated Aug 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03867200 Issued in NJ
Practice address
1460 Route 23
Wayne, NJ 07470-7503
Phone
(973) 908-0058
NPI assigned
Aug 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03867200 NJ Primary

Addresses

Primary practice location

1460 Route 23
Wayne, NJ 07470-7503

Mailing address

130 Beech Ter
Wayne, NJ 07470-5065

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
28RI03867200NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1502496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502496000000",
    "number": "1639694474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BEECH TER",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074705065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 ROUTE 23",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707503",
            "telephone_number": "973-908-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUMPF",
        "first_name": "CONRAD",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-12",
        "last_updated": "2017-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03867200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2017; 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.