MRS. STACEY SMITH (NPI# 1942664669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942664669 |
| Entity Type | Individual |
| Full Name | MRS. STACEY SMITH |
| Other Name | MISS MARY STACEY KERWIN |
| Practice Address |
124845 Main St Williston SC 29853-2711 |
| Practice Telephone | 8032664345 |
| Mailing Telephone | 8032664345 |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2016-04-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 8721 | SC | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | SC LLR BOARD OF PHARMACY | 8721 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790385771 | Stacey Smith | Physical Therapy Assistant | 24 Deer Run Rd, Little Egg Harbor Twp, NJ 08087-9722 | 2020-10-28 |
| 1205487139 | Stacey C Smith | Case Manager/Care Coordinator | 4166 Lindell Blvd Ste 1b, Saint Louis, MO 63108-2923 | 2019-09-23 |
| 1356812994 | Stacey Smith | Doula | 8711 Whitson Ct, Springfield, VA 22153-1268 | 2018-12-07 |
| 1871000745 | Stacey Smith | Counselor | 8622 Winton Rd Ste A, Cincinnati, OH 45231-4823 | 2018-01-02 |
| 1992150411 | Stacey Smith | Community Health Worker | 3042 Fitzgerald St, Jacksonville, FL 32254-3947 | 2016-05-03 |
| 1184085813 | Stacey Smith | Psychologist | 2211 S Mill Ave, Tempe, AZ 85282-2115 | 2016-03-08 |
| 1881011716 | Stacey Amanda Smith | Pharmacist | 4468 Eagle River Run, Broomfield, CO 80023-8753 | 2014-03-28 |
| 1164755765 | Stacey V Smith | Counselor | 69 Mascot St, Dorchester Center, MA 02124-4130 | 2009-09-14 |
| 1831357185 | Stacey Marie Smith | Specialist/Technologist, Other | 1816 N 155th St, Shoreline, WA 98133-6014 | 2008-05-22 |
| 1831375567 | Stacey Ann Smith | Respiratory Therapist, Registered | 783 Vista Del Sol, Prescott, AZ 86303-7268 | 2008-01-11 |
| Street Address |
124845 MAIN ST |
| City | WILLISTON |
| State | SC |
| Zip Code | 29853-2711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669989349 | Brittany Wyndham | Pharmacist | 12935 Main Street, Williston, SC 29853 | 2018-01-04 |
| 1467837633 | Billie Williams | Licensed Practical Nurse | 415 Memorial Ave., Allendale, SC 29853 | 2015-07-29 |
| 1003273145 | Angela Sharpe | Pharmacist | 2 E Main St, Williston, SC 29853 | 2016-01-20 |
| 1619211521 | Angela Nicole Marzolf | Occupational Therapy Assistant | 5721 Springfield Rd, Williston, SC 29853 | 2012-11-15 |
| 1134252588 | Carolina Rural Practice Management, Inc. | Clinic/Center | 2677 Main St, Williston, SC 29853-0177 | 2007-03-14 |
| 1669524260 | John Wade Riley | Dentist | 10 Roundtree St., Williston, SC 29853-0659 | 2007-01-17 |
| 1750379442 | Williston Healthcare and Rehab, LLC | Skilled Nursing Facility | 5721 Springfield Rd, Williston, SC 29853-1917 | 2005-10-07 |
| 1497096259 | Alice Pyle Metts | Physical Therapist | 5721 Springfield Rd, Williston, SC 29853-1917 | 2013-03-04 |
| 1700120128 | Elise Faulkner | Physical Therapist | 5721 Springfield Rd, Williston, SC 29853-1917 | 2012-11-26 |
| 1215271812 | Cheryl Lee Gentry | Physical Therapy Assistant | 5721 Springfield Rd, Williston, SC 29853-1917 | 2012-11-20 |
| Find all providers in zip 29853 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104435528 | Casey Nichols | Pharmacist | 1500 14th St W Ste 150, Williston, ND 58801-4080 | 2020-07-31 |
| 1669989349 | Brittany Wyndham | Pharmacist | 12935 Main Street, Williston, SC 29853 | 2018-01-04 |
| 1891039533 | Molly Mix Lewis | Pharmacist | 2466 St George Rd, Cvs, Williston, VT 05495-7432 | 2012-11-19 |
| 1386936540 | Brian Bruyns | Pharmacist | 600 Blair Park Rd, Suite 195, Williston, VT 05495-7586 | 2011-05-06 |
| 1144528407 | Wanda Platt | Pharmacist | 12845 Main St, Williston, SC 29853-2711 | 2011-03-09 |
| 1528277001 | Thomas Patrick Ryan Jr. | Pharmacist | 863 Harvest Lane, Williston, VT 05495 | 2007-05-22 |
| 1992829097 | M Jacklynn Estes | Pharmacist | 108 Cornerstone Dr, Williston, VT 05495-4034 | 2007-03-16 |
| 1013062363 | Lisa J.w. Borreson | Pharmacist | 317 Main, Williston, ND 58801 | 2007-01-25 |
| 1720146897 | Barbara F. Underhill | Pharmacist | 1811 Crest St, Williston, ND 58801-3315 | 2006-12-04 |
| 1356302889 | Corey James Duteau | Pharmacist | 434 Hurricane Ln Ste 200, Williston, VT 05495-2073 | 2006-04-02 |
| Find all providers in WILLISTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.