Active NPI
Lisa Elaine Stimson, RPH
- Pharmacist
- Fayetteville, GA
National Provider Identifier
1841822764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH019795
- Practice address
- 805 Glynn St S
Fayetteville, GA 30214-2000 - Phone
- (770) 461-8266
- Fax
- (770) 716-7471
- NPI assigned
- Feb 8, 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 | RPH019795 | GA | Primary |
Addresses
Primary practice location
805 Glynn St S
Fayetteville, GA 30214-2000
Mailing address
138 Rockspray RDG
Peachtree City, GA 30269-2488
Phone (678) 481-1277
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH019795 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Kroger Co | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581120000000",
"number": "1841822764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 ROCKSPRAY RDG",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "302692488",
"telephone_number": "678-481-1277",
"fax_number": "770-716-7471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 GLYNN ST S",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302142000",
"telephone_number": "770-461-8266",
"fax_number": "770-716-7471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STIMSON",
"first_name": "LISA",
"middle_name": "ELAINE",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-08",
"last_updated": "2020-02-08",
"certification_date": "2020-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH019795",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.