Active NPI
Amy Joleen Bucknell, PHARMD
- Pharmacist
- Waterloo, IA
National Provider Identifier
1033436993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19174
- Practice address
- 146 W Dale St Ste 103
Waterloo, IA 50703-1901 - Phone
- (319) 235-3171
- Fax
- (319) 235-3134
- NPI assigned
- Apr 30, 2010
- 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 | 19174 | IA | Primary |
Addresses
Primary practice location
146 W Dale St Ste 103
Waterloo, IA 50703-1901
Mailing address
146 W Dale St Ste 103
Waterloo, IA 50703-1901
Phone (319) 235-3171
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 |
|---|---|---|---|
| 19174 | IA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allen Memorial Hospital Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinic Pharmacy
- Waterloo, IA
- NPI 1659461572
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272585600000",
"number": "1033436993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "146 W DALE ST STE 103",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507031901",
"telephone_number": "319-235-3171",
"fax_number": "319-235-3134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "146 W DALE ST STE 103",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507031901",
"telephone_number": "319-235-3171",
"fax_number": "319-235-3134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKNELL",
"first_name": "AMY",
"middle_name": "JOLEEN",
"name_prefix": "Mrs.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-30",
"last_updated": "2010-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "19174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.