Stacey Mudd-Ray, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

041506 Issued in MO

Practice address

455 Highway 61 N
Hannibal, MO 63401-2885

Phone

(573) 221-6557

Fax

(573) 248-8041

NPI assigned

Sep 27, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

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.

• Walgreen Co

  • Pharmacy
  • Hannibal, MO
  • NPI 1194730341
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1851674758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 CABIN CLUB DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620027414",
            "telephone_number": "618-550-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 HIGHWAY 61 N",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634012885",
            "telephone_number": "573-221-6557",
            "fax_number": "573-248-8041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDD-RAY",
        "first_name": "STACEY",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "041506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Mobley, MEC, PLPC
• Elizabeth Marie Monroe, O.D.
• Angela M Montgomery
• Edwina Morriss-Hirner, LCSW, MSW
• Lisa Morrow, MA, LPC
• Kenneth R Mueller, O.D.
• Allyson Lynn Munch, DO
• Marshall Vernon Munch, O.D.
• Robert Francis Munsch, M.D.
• Jessica Murfin

• Pharmacist in Hannibal, MO
• Providers in Hannibal, MO by specialty
• Pharmacist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.