Active NPI
Lauren Ann Liston, RPH
- Pharmacist
- Satellite Beach, FL
National Provider Identifier
1861970782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS57992
- Practice address
- 1024 Florida A1A
#120
Satellite Beach, FL 32937 - Phone
- (321) 773-7035
- NPI assigned
- Aug 2, 2018
- Sex
- Female
- Sole proprietor
- No
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 | PS57992 | FL | Primary |
Addresses
Primary practice location
1024 Florida A1A
#120
Satellite Beach, FL 32937
Mailing address
1420 Dalbora Rd
Merritt Island, FL 32953-7136
Phone (321) 501-8881
Other names 1
- Lauren Ann Waller
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 |
|---|---|---|---|
| PS57992 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Publix Super Markets Inc | Past | Accepting new patients | |
| Publix Super Markets 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.
-
dba Publix Pharmacy #2107
- Community/Retail Pharmacy
- Winter Haven, FL
- NPI 1760356380
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566777600000",
"number": "1861970782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 DALBORA RD",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329537136",
"telephone_number": "321-501-8881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1024 FLORIDA A1A",
"address_2": "#120",
"city": "SATELLITE BEACH",
"state": "FL",
"postal_code": "32937",
"telephone_number": "321-773-7035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISTON",
"first_name": "LAUREN",
"middle_name": "ANN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-02",
"last_updated": "2019-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS57992",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LAUREN",
"last_name": "WALLER",
"middle_name": "ANN",
"credential": "RPH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Satellite Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.