Active NPI
Amanda Diane Peterson, PHARMD
- Pharmacist
- Tulsa, OK
National Provider Identifier
1013651934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17733
- Practice address
- 207 S Memorial Dr
Tulsa, OK 74112-2201 - Phone
- (918) 838-2937
- NPI assigned
- Apr 26, 2022
- 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 | 17733 | OK | Primary |
Addresses
Primary practice location
207 S Memorial Dr
Tulsa, OK 74112-2201
Mailing address
207 S Memorial Dr
Tulsa, OK 74112-2201
Phone (918) 838-2937
Other names 1
- Dr. Amanda Diane Sadofsky
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17733 | OK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650931200000",
"number": "1013651934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 S MEMORIAL DR",
"city": "TULSA",
"state": "OK",
"postal_code": "741122201",
"telephone_number": "918-838-2937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 S MEMORIAL DR",
"city": "TULSA",
"state": "OK",
"postal_code": "741122201",
"telephone_number": "918-838-2937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "AMANDA",
"middle_name": "DIANE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-26",
"last_updated": "2022-04-26",
"certification_date": "2022-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "17733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "SADOFSKY",
"middle_name": "DIANE",
"prefix": "DR.",
"credential": "PHARMD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.