Active NPI
Stephanie Ann Roush, PHARMD
- Pharmacist
- Indianapolis, IN
National Provider Identifier
1669604161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2010029502
- Practice address
- 6925 W 38TH St
Indianapolis, IN 46254-3905 - Phone
- (314) 537-6372
- NPI assigned
- Aug 17, 2009
- Sex
- Female
- 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 | 2010029502 | MO | Primary |
Addresses
Primary practice location
6925 W 38TH St
Indianapolis, IN 46254-3905
Mailing address
175 Flower Valley Shopping Ctr
Florissant, MO 63033-1643
Phone (314) 837-8052
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 |
|---|---|---|---|
| 2010029502 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supervalu Pharmacies Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Burnsville, MN
- NPI 1093517914
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368057600000",
"number": "1669604161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 FLOWER VALLEY SHOPPING CTR",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630331643",
"telephone_number": "314-837-8052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6925 W 38TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462543905",
"telephone_number": "314-537-6372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUSH",
"first_name": "STEPHANIE",
"middle_name": "ANN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-17",
"last_updated": "2013-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "2010029502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.