Individual provider Active NPI

Amy Robertson

  • Pharmacist
  • Duncan, OK
National Provider Identifier
1033779228
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15121 Issued in OK
Practice address
3117 N Hwy 81
Duncan, OK 73533-9283
Phone
(580) 252-0140
Fax
(580) 252-0143
NPI assigned
Jun 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Health Educator 174H00000X
Geriatric Pharmacist 1835G0303X 15121 OK
Nutrition Support Pharmacist 1835N1003X 15121 OK
Clinical Pharmacology Physician 208U00000X 15121 OK
Pharmacist 183500000X 15121 OK Primary

Addresses

Primary practice location

3117 N Hwy 81
Duncan, OK 73533-9283

Mailing address

3117 N Hwy 81
Duncan, OK 73533-9283
Phone (580) 252-0140

Other practice location 1

821 W Main St
Duncan, OK 73533-4615
Phone (580) 255-6292

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

State licenses

LicenseStateTypeSpecialty
15121OKMDClinical Pharmacology Physician

NPI Registry JSON

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1033779228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 N HWY 81",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735339283",
            "telephone_number": "580-252-0140",
            "fax_number": "580-252-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3117 N HWY 81",
            "city": "DUNCAN",
            "state": "OK",
            "postal_code": "735339283",
            "telephone_number": "580-252-0140",
            "fax_number": "580-252-0143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 W Main St",
            "address_purpose": "LOCATION",
            "city": "Duncan",
            "state": "OK",
            "postal_code": "735334615",
            "country_code": "US",
            "telephone_number": "580-255-6292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "OK",
            "license": "15121",
            "primary": false
        },
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "OK",
            "license": "15121",
            "primary": false
        },
        {
            "code": "208U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Pharmacology",
            "state": "OK",
            "license": "15121",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "15121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncan, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.

Verify at the official NPI Registry.