Active NPI
Stacy Anderson
- Pharmacist
- Grand Junction, CO
National Provider Identifier
1710114038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- A10003721
- Practice address
- 1401 N 1St St
Grand Junction, CO 81501-2139 - Phone
- (970) 243-3411
- Fax
- (866) 491-5888
- NPI assigned
- Jun 12, 2009
- Last updated
- Nov 5, 2019
- 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 | A10003721 | DE | Primary |
Addresses
Primary practice location
1401 N 1St St
Grand Junction, CO 81501-2139
Mailing address
1401 N 1St St
Grand Junction, CO 81501-2139
Phone (970) 243-3411
Other practice location 1
1401 N 1st St
Grand Junction, CO 81501-2139
Phone (970) 243-3411
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHA0021987 | Other | CO | PHARMACIST 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 |
|---|---|---|---|
| A10003721 | DE | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Colorado State Infusion, Inc. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Home Infusion Therapy Pharmacy
- Grand Junction, CO
- NPI 1689714495
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572912000000",
"number": "1710114038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 N 1ST ST",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815012139",
"telephone_number": "970-243-3411",
"fax_number": "866-491-5888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 N 1ST ST",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815012139",
"telephone_number": "970-243-3411",
"fax_number": "866-491-5888"
}
],
"practiceLocations": [
{
"address_1": "1401 N 1st St",
"address_purpose": "LOCATION",
"city": "Grand Junction",
"state": "CO",
"postal_code": "815012139",
"country_code": "US",
"telephone_number": "970-243-3411",
"fax_number": "866-491-5888",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDERSON",
"first_name": "STACY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-12",
"last_updated": "2019-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "DE",
"license": "A10003721",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "PHA0021987",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Junction, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.