Active NPI
Stefan Jones
- Pharmacist
- Sulphur, OK
National Provider Identifier
1649870106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16783
- Practice address
- 2705 W Broadway Ave
Sulphur, OK 73086-6508 - Phone
- (580) 622-6181
- NPI assigned
- Oct 26, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 16783 | OK | Primary |
Addresses
Primary practice location
2705 W Broadway Ave
Sulphur, OK 73086-6508
Mailing address
2510 Milton Rd
Sulphur, OK 73086-1143
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16783 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East, LP | Past | Accepting new patients | |
| Wal-Mart Stores East LP | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Walmart Pharmacy 10-0225
- Community/Retail Pharmacy
- Sulphur, OK
- NPI 1316964430
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603670400000",
"number": "1649870106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2510 MILTON RD",
"city": "SULPHUR",
"state": "OK",
"postal_code": "730861143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2705 W BROADWAY AVE",
"city": "SULPHUR",
"state": "OK",
"postal_code": "730866508",
"telephone_number": "580-622-6181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "STEFAN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-10-26",
"last_updated": "2020-10-26",
"certification_date": "2020-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "16783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sulphur, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.