Active NPI
Amanda Renee Freeman
- Pharmacist
- Tulsa, OK
National Provider Identifier
1083214118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14528
- Practice address
- 10938 S Memorial Dr
Tulsa, OK 74133-7352 - Phone
- (918) 394-4075
- NPI assigned
- Oct 28, 2020
- Last updated
- Oct 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 14528 | OK | Primary |
Addresses
Primary practice location
10938 S Memorial Dr
Tulsa, OK 74133-7352
Mailing address
1009 S 72ND St
Broken Arrow, OK 74014-2861
Phone (918) 978-9773
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14528 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East LP | Past | Accepting new patients | |
| Wal-Mart Stores East, LP | 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.
-
dba Wal-Mart Pharmacy 10-1597
- Community/Retail Pharmacy
- Tulsa, OK
- NPI 1174541833
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603843200000",
"number": "1083214118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 S 72ND ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740142861",
"telephone_number": "918-978-9773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10938 S MEMORIAL DR",
"city": "TULSA",
"state": "OK",
"postal_code": "741337352",
"telephone_number": "918-394-4075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEMAN",
"first_name": "AMANDA",
"middle_name": "RENEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-28",
"last_updated": "2020-10-28",
"certification_date": "2020-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "14528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.