NPIMap

Individual provider Active NPI

Joseph Vincent Stodola III, RPH

  • Pharmacist
  • Hammond, IN
National Provider Identifier
1902176209
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26011215A Issued in IN
Practice address
6510 Columbia Ave
Hammond, IN 46320-2748
Phone
(219) 931-3332
Fax
(219) 852-9201
NPI assigned
Jan 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26011215A IN Primary

Addresses

Primary practice location

6510 Columbia Ave
Hammond, IN 46320-2748

Mailing address

6510 Columbia Ave
Hammond, IN 46320-2748
Phone (219) 931-3332

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

LicenseStateTypeSpecialty
26011215AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co 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.

NPI Registry JSON

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1902176209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 COLUMBIA AVE",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463202748",
            "telephone_number": "219-931-3332",
            "fax_number": "219-852-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 COLUMBIA AVE",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463202748",
            "telephone_number": "219-931-3332",
            "fax_number": "219-852-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODOLA",
        "first_name": "JOSEPH",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-04",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26011215A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.