Active NPI
Stephanie McElroy-Liddell, PHARM D
- Pharmacist
- Pearl, MS
National Provider Identifier
1750982104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E-09973
- Practice address
- 90 Bass Pro Dr
Pearl, MS 39208-9242 - Phone
- (601) 939-6442
- NPI assigned
- Nov 3, 2020
- 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 | E-09973 | MS | Primary |
Addresses
Primary practice location
90 Bass Pro Dr
Pearl, MS 39208-9242
Mailing address
813 Creston Dr
Byram, MS 39272-3003
Phone (601) 454-4697
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 |
|---|---|---|---|
| E-09973 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sams East Inc | Past | Accepting new patients | |
| Sams East Inc | 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Pearl, MS
- NPI 1285868653
-
- Community/Retail Pharmacy
- Bangor, ME
- NPI 1457378721
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604361600000",
"number": "1750982104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "813 CRESTON DR",
"city": "BYRAM",
"state": "MS",
"postal_code": "392723003",
"telephone_number": "601-454-4697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 BASS PRO DR",
"city": "PEARL",
"state": "MS",
"postal_code": "392089242",
"telephone_number": "601-939-6442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCELROY-LIDDELL",
"first_name": "STEPHANIE",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-03",
"last_updated": "2020-11-03",
"certification_date": "2020-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-09973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pearl, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.