Active NPI
Lisa Fillmore
- Pharmacist
- Ada, OK
National Provider Identifier
1699855296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9926
- Practice address
- 1007 N Country Club Rd
Ada, OK 74820-2847 - Phone
- (580) 421-6260
- Fax
- (580) 559-0610
- NPI assigned
- Oct 17, 2006
- 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 | 9926 | OK | Primary |
Addresses
Primary practice location
1007 N Country Club Rd
Ada, OK 74820-2847
Mailing address
1001 N Country Club Rd
Ada, OK 74820-2847
Phone (580) 421-4570
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9926 | Other | OK | OK LICENSE |
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 |
|---|---|---|---|
| 9926 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185148800000",
"number": "1699855296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 N COUNTRY CLUB RD",
"city": "ADA",
"state": "OK",
"postal_code": "748202847",
"telephone_number": "580-421-4570",
"fax_number": "580-421-6283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 N COUNTRY CLUB RD",
"city": "ADA",
"state": "OK",
"postal_code": "748202847",
"telephone_number": "580-421-6260",
"fax_number": "580-559-0610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FILLMORE",
"first_name": "LISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "9926",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OK LICENSE",
"identifier": "9926",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ada, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.