Individual provider Active NPI

Stephan R Draughan, PHARMD

  • Pharmacist
  • Decatur, IL
National Provider Identifier
1851694053
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051293516 Issued in IL
Practice address
1155 E Pershing Rd
Decatur, IL 62526-4726
Phone
(217) 877-2374
NPI assigned
Dec 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051293516 IL Primary

Addresses

Primary practice location

1155 E Pershing Rd
Decatur, IL 62526-4726

Mailing address

37 Royal Rd
Springfield, IL 62702-1527
Phone (217) 793-1324

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

LicenseStateTypeSpecialty
051293516ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1851694053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 ROYAL RD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627021527",
            "telephone_number": "217-793-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 E PERSHING RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264726",
            "telephone_number": "217-877-2374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAUGHAN",
        "first_name": "STEPHAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-09",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051293516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; 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.