Individual provider Active NPI

Lisa Wilson Stanley

  • Pharmacist
  • Fairhope, AL
National Provider Identifier
1770122335
Registry record updated Dec 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
12491 Issued in AL
Practice address
100 Gilbreath Ave
Fairhope, AL 36532-4998
Phone
(251) 377-2809
NPI assigned
Dec 31, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 12491 AL Primary

Addresses

Primary practice location

100 Gilbreath Ave
Fairhope, AL 36532-4998

Mailing address

100 Gilbreath Ave
Fairhope, AL 36532-4998
Phone (251) 377-2809

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
12491ALMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1577750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1770122335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GILBREATH AVE",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365324998",
            "telephone_number": "251-377-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GILBREATH AVE",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365324998",
            "telephone_number": "251-377-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "LISA",
        "middle_name": "WILSON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-31",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "12491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.

Verify at the official NPI Registry.