Individual provider Active NPI

Amanda Jo Storrusten, PHARMD

  • Pharmacist
  • West Fargo, ND
National Provider Identifier
1063085306
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH6327 Issued in ND
Practice address
750 23Rd Ave E
West Fargo, ND 58078-7804
Phone
(701) 281-2222
NPI assigned
Jul 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH6327 ND Primary

Addresses

Primary practice location

750 23Rd Ave E
West Fargo, ND 58078-7804

Mailing address

750 23Rd Ave E
West Fargo, ND 58078-7804
Phone (701) 281-2222

Other practice location 1

4677 49th Ave S Apt 103
Fargo, ND 58104-4478
Phone (701) 740-6928

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

LicenseStateTypeSpecialty
RPH6327NDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1063085306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 23RD AVE E",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580787804",
            "telephone_number": "701-281-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 23RD AVE E",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580787804",
            "telephone_number": "701-281-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4677 49th Ave S Apt 103",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581044478",
            "country_code": "US",
            "telephone_number": "701-740-6928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STORRUSTEN",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ND",
            "license": "RPH6327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.

Verify at the official NPI Registry.