Individual provider Active NPI

Stephen Wraith

  • Pharmacist
  • El Paso, TX
National Provider Identifier
1700240769
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
54565 Issued in TX
Practice address
6375 Montana Ave
El Paso, TX 79925-2044
Phone
(915) 772-1402
NPI assigned
Apr 6, 2016
Last updated
Apr 6, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 54565 TX Primary

Addresses

Primary practice location

6375 Montana Ave
El Paso, TX 79925-2044

Mailing address

6375 Montana Ave
El Paso, TX 79925-2044

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
54565TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1700240769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6375 MONTANA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799252044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6375 MONTANA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799252044",
            "telephone_number": "915-772-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAITH",
        "first_name": "STEPHEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "54565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.