Active NPI
Andrea Knutson, PHARMD
- Pharmacist
- New Haven, IN
National Provider Identifier
1033984612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 45021856A
- Practice address
- 907 Lincoln Hwy W
New Haven, IN 46774-2141 - Phone
- (260) 493-3736
- NPI assigned
- Nov 23, 2023
- Last updated
- Nov 23, 2023
- 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 | 45021856A | IN | Primary |
Addresses
Primary practice location
907 Lincoln Hwy W
New Haven, IN 46774-2141
Mailing address
1801 Lake Ave
Fort Wayne, IN 46805-5339
Phone (260) 413-1644
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 |
|---|---|---|---|
| 45021856A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700697600000",
"number": "1033984612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 LAKE AVE",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468055339",
"telephone_number": "260-413-1644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "907 LINCOLN HWY W",
"city": "NEW HAVEN",
"state": "IN",
"postal_code": "467742141",
"telephone_number": "260-493-3736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUTSON",
"first_name": "ANDREA",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-23",
"last_updated": "2023-11-23",
"certification_date": "2023-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IN",
"license": "45021856A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.